Evidence map›Paper›PMID 41817775›Full record

SynthesisWorld journal of urology2026

Efficacy and safety of retrograde intrarenal surgery with a flexible and navigable suction sheath (FANS-RIRS) versus mini-percutaneous nephrolithotomy (mPCNL) for 2-3 cm renal stones: a systematic review and meta-analysis of randomized controlled trials.

Yulong Li, Zhuoyue Yao, Zhongbao Zhou, Hanchuan Wang, Yong Zhang, Huantao Zong

Abstract readMeta-AnalysisSystematic ReviewComparative Study
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Yulong Li *Department of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Zhuoyue Yao *Department of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Zhongbao ZhouDepartment of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Hanchuan WangDepartment of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
Yong ZhangDepartment of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. doctorzhangyong@yeah.net.
Huantao ZongDepartment of Urology, Beijing TianTan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China. huantao168@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe optimal treatment for 2-3 cm renal stones requires balancing efficacy with minimal invasiveness. While mini-percutaneous nephrolithotomy (mPCNL) is a standard approach, retrograde intrarenal surgery with a Flexible and Navigable Suction Sheath (FANS-RIRS) has emerged as a promising alternative. We conducted a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of these two procedures.

methodsA systematic search of PubMed, Embase, Web of Science, and CENTRAL was conducted through August 2025 to identify RCTs comparing FANS-RIRS and mPCNL for 2-3 cm renal stones. Primary outcomes included stone-free rates (SFRs), perioperative variables, and safety profiles, including hemorrhagic and infectious complications. Evidence was synthesized using random-effects models, and certainty was assessed with the GRADE framework.

resultsThree high-quality RCTs enrolling 1020 patients were included. Final SFRs were comparable between FANS-RIRS and mPCNL (OR 0.80, 95% CI 0.51-1.24; P = 0.31). However, FANS-RIRS was associated with significant advantages in safety and recovery, including a smaller hemoglobin decline (MD - 5.36 g/L), lower rates of hemorrhage (OR 0.08) and blood transfusion (OR 0.14), a shorter hospital stay (MD - 1.75 days), and less postoperative pain (all P < 0.05). Operative time, auxiliary procedure rates, and infectious complications did not differ significantly between groups. The certainty of evidence for outcomes was rated as moderate to low due to the small number of studies and heterogeneity.

conclusionCurrent evidence from randomized trials suggests that for 2-3 cm renal stones, FANS-RIRS may provide efficacy comparable to mPCNL but with a potentially superior safety profile and faster patient recovery. While promising, these findings are based on a limited number of RCTs, and FANS-RIRS appears to be a viable option, particularly for patients who have a high bleeding risk or prioritize a quicker return to normal activities. TRIAL REGISTRATION NUMBER: This study was prospectively registered in PROSPERO (CRD420251136058).

Indexed as

Kidney CalculiNephrolithotomy, PercutaneousHumansRandomized Controlled Trials as TopicSuctionTreatment OutcomeFlexible and navigable suction sheathMeta-analysisMini-percutaneous nephrolithotomy (mPCNL)NephrolithiasisRetrograde intrarenal surgery (RIRS)Stone-free rate

Identifiers

PMID41817775

What OpenQuestion holds

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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.