Evidence map›Paper›PMID 39921731›Full record

ArticleWorld journal of urology2025

General anaesthesia with gated or controlled mechanical ventilation and its influence on peri and post operative outcomes of retrograde intra renal surgery when using flexible and navigable suction access sheath, an EAU-endourology and Global FANS collaborative study group: a prospective study.

Ee Jean Lim, Bhaskar Kumar Somani, Mehmet Ilker Gokce, Chin Tiong Heng, Ashish Ranjan Satapathy, Jose Ivan Robles, Tsung Wen Chong, Khi Yung Fong, Daniele Castellani, Naeem Bhojani and 9 more

Abstract readClinical StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. The future of endourology is now.World journal of urology · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Ee Jean LimDepartment of Urology, Singapore General Hospital, Academia Level 5, 20 College Rd, Singapore, 169856, Singapore. eejeanlim@gmail.com.
Bhaskar Kumar SomaniUniversity Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
Mehmet Ilker GokceDepartment of Urology, Ankara University School of Medicine, Ankara, Turkey.
Chin Tiong HengDepartment of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.
Ashish Ranjan SatapathyDepartment of Anaesthesiology, Ng Teng Fong General Hospital, Singapore, Singapore.
Jose Ivan RoblesTorres Hospital Universitario, Monterrey, Nuevo León, México.
Tsung Wen ChongDepartment of Urology, Singapore General Hospital, Academia Level 5, 20 College Rd, Singapore, 169856, Singapore.
Khi Yung FongYong Loo Lin School of Medicine, National University of Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.
Daniele CastellaniUrology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Italy.
Naeem BhojaniDivision of Urology, University of Montreal, Centre Hospitalier de l'Université de Montréal, 900 St Denis R04.442, Montreal, QC, H2X, Canada.
Hatem KamkoumAisha bint Hamad al-Attiyah Hospital (Hamad Medical Corporation), Tinbak, Qatar.
Nariman GadzhievDepartment of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia.
Vigen MalkhasyanUrology Unit, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.
Von Vee NgDepartment of Anaesthesiology, Singapore General Hospital, Academia Level 5, 20 College Rd, Singapore, 169856, Singapore.
Saeed Bin HamriDivision of Urology, Department of Surgery, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.
Steffi Kar-Kei YuenDepartment of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China.
Thomas R W HerrmannDepartment of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland.
Oliver TraxerDepartment of Urology Hôpital Tenon, Sorbonne University, Paris, France.
Vineet GauharDepartment of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRetrograde intrarenal surgery (RIRS) is a preferred treatment for renal stones, yet challenges such as kidney movement due to respiration hinder surgical precision and outcomes. The introduction of flexible and navigable suction ureteral access sheaths (FANS) and novel techniques like gated respiration aim to improve stone-free rates (SFR) and reduce complications. This study evaluates the impact of gated respiration on perioperative outcomes in RIRS with FANS.

methodsA prospective multicenter study enrolled 562 adult patients undergoing RIRS with FANS under general anesthesia. Patients were divided into two groups: non-gated respiration (Group 1) and gated respiration (Group 2). Stone-free status (SFS) was assessed at 30 days using NCCT scans. SFS was defined as follows: grade A, zero fragments; grade B, a single fragment ≤ 2 mm; grade C, a single fragment 2.1-4 mm; and grade D, single/multiple fragments > 4 mm. Procedural efficiency, perioperative complications, and surgeon-reported outcomes were compared.

resultsPatients in Group 2 had significantly higher zero residual fragment (Grade A) rates (64.2% vs. 59%) and overall SFR (Grade A + B: 98.3% vs. 91.3%, p = 0.001). Gated respiration improved sheath navigation (91.2% vs. 85.1%, p = 0.038) and visibility during lithotripsy (p = 0.004), while reducing complications like mild bleeding due to sheath movement (3.1% vs. 11.2%, p < 0.001). Logistic regression identified gated respiration as a significant predictor of SFS (OR 6.26, 95% CI 2.28-22.6, p < 0.001).

conclusionGated respiration synergistically enhances the efficacy of FANS in RIRS, improving SFR, procedural safety, and surgeon experience. This study highlights the importance of respiratory control as an adjunct to RIRS, emphasizing the need for interdisciplinary collaboration between surgical and anesthesiology teams.

Indexed as

Anesthesia, GeneralKidney CalculiRespiration, ArtificialAdultAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsProspective StudiesSuctionTreatment OutcomeFANSGated respirationKidney calculiRIRSSFR

Identifiers

PMID39921731

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.