ArticleFrontiers in surgery2026
Comparison of vacuum-assisted flexible ureteroscopy and percutaneous nephrolithotomy for 2-3 cm upper tract stones: a real-world cohort study.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This real-world study aimed to compare the perioperative and recovery outcomes of single-use digital flexible ureterorenoscopy with a flexible-tip vacuum-assisted ureteral access sheath (FV-UAS) against standard percutaneous nephrolithotomy (PCNL) for managing upper urinary tract stones measuring 2-3 cm. Patients and methods: This single-center, retrospective cohort study enrolled 116 patients (69 FV-UAS, 47 PCNL) between January 2023 and December 2024. The co-primary outcomes were the stone-free rate (SFR) on postoperative day 1 and at 1 month. The SFR on postoperative day 1 was assessed by kidney-ureter-bladder (KUB) radiography or ultrasound, while the SFR at 1 month was assessed by non-contrast computed tomography (NCCT). Secondary outcomes included operative time, length of hospital stay (LOS), hydronephrosis resolution at 90 days, complication rates, and trends in serum creatinine and neutrophil-to-lymphocyte ratio (NLR). Results: Baseline characteristics were comparable. While the FV-UAS group demonstrated a numerically higher immediate SFR (92.75% vs. 76.59%, Conclusion: In this real-world study, the FV-UAS technique for 2-3 cm upper tract stones was associated with comparable outcomes and stone clearance compared to PCNL. It offered excellent stone clearance, faster recovery, reduced postoperative pain and inflammation, and a more favorable safety profile, particularly regarding bleeding. FV-UAS represents a compelling minimally invasive alternative for selected patients in this stone size category.
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