ReviewTurkish journal of urology2020
Endoscopic combined intrarenal surgery (ECIRS) - Tips and tricks to improve outcomes: A systematic review.
Review in Turkish journal of urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06085794 (Comparative Study Between Standard PCNL and Endoscopic Combined Intrarenal Surgery), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparative Study Between Standard PCNL and Endoscopic Combined Intrarenal Surgery (ECIRS) in the Galdakaomodified Supine Valdivia (GMSV) Position for Complex Nephrolithiasis in Obese Patients
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- International Alliance of Urolithiasis (IAU) guidelines on the management of pediatric urolithiasis.Urolithiasis · 2024Guideline
- Cost of reusable vs. single-use ureteroscopes in complex renal surgeries: a randomized cohort study.World journal of urology · 2025Trial
- Endoscopic combined intrarenal surgery versus prone percutaneous nephrolithotomy for complex renal stones: critical assessment of a randomized trial.International urology and nephrology · 2025Trial
- Use of Novel 6.3 Fr Ureteroscope in Endoscopic Combined Intrarenal Surgery (ECIRS): Comparative Experience with Conventional Ureteroscopes.Journal of clinical medicine · 2026Article
- The Changing Landscape of Urological Surgery: 10-Year Trends in Benign Prostatic Hyperplasia and Upper Urinary Tract Stone Management in the San-in Region, Japan.Yonago acta medica · 2026Article
- Endoscopic combined intrarenal surgery: From percutaneous nephrolithotomy to the future of stone management.Investigative and clinical urology · 2026Review
- Feasibility and efficiency of the use of pulsed thulium: YAG (Thulio) laser for ECIRS: a multicenter evaluation.World journal of urology · 2026Article
- Kidney stone disease: phenomenological perspectives.Medicine, health care, and philosophy · 2026Article
- Managing Radiation Exposure to Endourologists during Pregnancy.Current urology reports · 2025Review
- Tubeless Percutaneous Nephrolithotomy in the Barts 'Flank-Free' Modified Supine Position with 24-Hour Discharge: A Single-Center Experience.Medicina (Kaunas, Lithuania) · 2025Article
- The impact of antegrade guidewire positioning outside the external urethral meatus in supine PCNL: the through and through technique.Urolithiasis · 2025Article
- Comprehensive surgical strategy for incarcerated ureteral calculi in the context of double renal pelvis malformations: A case report.International journal of surgery case reports · 2025Article
- Endoscopic Combined Intrarenal Surgery for a Large Stone in a Rare Fused Supernumerary Kidney.Cureus · 2024Article
- Comparative efficacy of different surgical techniques for pediatric urolithiasis-a systematic review and meta-analysis.Translational andrology and urology · 2024Article
- Endoscopic combined intrarenal surgery for successful removal of an encrusted ureteral stent and multiple renal stones in solitary kidney: A case report.International journal of surgery case reports · 2024Article
- Nonpapillary Prone Endoscopic Combined Intrarenal Surgery (ECIRS): Five-Year Experience and Outcomes from a High-Volume Center.Journal of clinical medicine · 2024Article
- A new training model using the self-healing properties of supramolecular hydrogels for endoscopic combined intrarenal surgery.Urolithiasis · 2023Article
- Miniaturization in percutaneous nephrolithotomy: What is new?Asian journal of urology · 2023Review
- Ureteroscopy in Patients with Urinary Diversion: Outcomes and Lessons Learned from Two European Centres.European urology open science · 2023Article
- Endoscopic combined intrarenal surgery for renal allograft lithiasis using "sheath-connection technique": A case report.Urology case reports · 2023Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed at assessing current efficacy and safety of endoscopic combined intrarenal surgery (ECIRS) for the treatment of large and/or complex urolithiasis and identifying relevant tips and tricks able to improve its outcomes, mainly deriving from the adjunct of retrograde flexible ureteroscopy to the traditional antegrade approach of percutaneous nephrolithotomy (PNL). MATERIAL AND
methodsA systematic review was conducted using relevant databases (Ovid Medline, PubMed, Scopus, and Web of Sciences), employing "ECIRS" as the search term in all cases, and then adding "endoscopic combined intrarenal surgery" and "flexible ureteroscopy AND percutaneous nephrolithotomy" as search terms for PubMed and Scopus. Original articles and systematic reviews were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Additionally, the reference lists of the selected publications were checked manually.
resultsA total of 14 studies were selected for analysis: two systematic reviews, one randomized controlled trial, five nonrandomized comparative studies, three prospective case series, and three retrospective case series. ECIRS achieves high stone-free rates and rather low/low Clavien-Dindo grade complication rates, confirming the role of retrograde ureteroscopy in the maximization of its efficacy and safety. A narrative synthesis of the most recognized tips and tricks of ECIRS is provided.
conclusionThe contribution of retrograde flexible ureteroscopy during PNL is essential. It plays a dual role, both diagnostic and active, allowing tailoring of the procedure to the patient, urolithiasis, and anatomy of the collecting system and optimization of the PNL efficacy and safety. This is ECIRS: an updated, complete, and versatile version of PNL.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.