Evidence map›Paper›PMID 40252099›Full record

ArticleUrolithiasis2025

Comparison of flexible ureteroscopic suction techniques: efficacy and safety of flexible and navigable access sheath (FANS) vs. direct in-scope suction (DISS) in the management of 2-3 cm lower pole renal stones.

Ümit Yildirim, Mehmet Uslu, Mehmet Ezer, Çağlayan Erdoğdu, Ramazan Kocaaslan, Kemal Sarica

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Urolithiasis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
–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

10 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
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  7. Review
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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

6 authors.

Ümit YildirimDepartment of Urology, Faculty of Medicine, Kafkas University, Kars, Türkiye. dr.umityildirim87@gmail.com.ORCID http://orcid.org/0000-0003-3065-9001
Mehmet UsluDepartment of Urology, Faculty of Medicine, Kafkas University, Kars, Türkiye.ORCID https://orcid.org/0000-0002-8370-3793
Mehmet EzerDepartment of Urology, Faculty of Medicine, Kafkas University, Kars, Türkiye.ORCID https://orcid.org/0000-0003-4422-6768
Çağlayan ErdoğduDepartment of Urology, Faculty of Medicine, Kafkas University, Kars, Türkiye.ORCID https://orcid.org/0009-0007-4205-5455
Ramazan KocaaslanDepartment of Urology, Faculty of Medicine, Kafkas University, Kars, Türkiye.ORCID https://orcid.org/0000-0003-1944-7059
Kemal SaricaDepartment of Urology, Sancaktepe Şehit Prof.Dr. İlhan Varank Training And Research Hospital, Istanbul, Türkiye.ORCID https://orcid.org/0000-0002-2473-1313

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study compares the efficacy and safety of two techniques for flexible ureteroscopy (FURS) in managing 2-3 cm lower pole renal stones: the use of flexible and navigable access sheath (FANS) versus direct in-scope suction (DISS) without an access sheath. A retrospective analysis of 60 patients undergoing FURS for lower pole renal stones was conducted between March 2023 and January 2025. Group 1 (n = 32) underwent FANS-assisted procedures, while Group 2 (n = 28) underwent sheathless FURS with DISS. Stone-free rates (SFR) were assessed with non-contrast computed tomography (NCCT) after four weeks. Operative time, peri- and postoperative complications, and hospitalization duration were also compared. The mean operative time was significantly shorter in the FANS group (71.8 ± 11.5 min) compared to the DISS group (79.1 ± 11.7 min, p = 0.026). The difference between the SFRs obtained in the FANS group (62.5%) and the DISS group (46.4%) after the first session was not statistically significant (p = 0.162). After the second session, SFRs were also comparable (87.5% vs. 82.1%, p = 0.412) (Residual stones < 4 mm were considered stone-free). Completely stone-free rates (CSFR), defined as the absence of residual fragments after the first session were 43.7% in the FANS group and 32.1% in the DISS group (p = 0.256), while after the second session, these rates increased to 84.3% and 75%, respectively (p = 0.280). Postoperative fever rates (9.3% vs. 10.7%, p = 0.598) and hospitalization duration (2.5 ± 1.3 vs. 2.6 ± 1.4 days, p = 0.819) were similar. Both techniques achieved high overall SFRs for large lower pole stones in a staged manner. However, FANS was associated with a shorter operative time. While DISS eliminates the need for an access sheath, its longer operative time may be a limitation. Larger studies are needed to further evaluate these techniques.

Indexed as

Kidney CalculiUreteroscopesUreteroscopyAdultAgedFemaleHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsRetrospective StudiesSuctionTreatment OutcomeAccess sheathDirect in scopeFlexibleLower poleNavigableSuction

Identifiers

PMID40252099
PMCPMC12009226

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Registered trials

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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.