ArticleTherapeutic advances in urology
Comparison of the efficacy and safety of flexible vacuum-assisted ureteral access sheath-assisted flexible ureteroscopic lithotripsy, conventional ureteral access sheath-assisted flexible ureteroscopic lithotripsy, and mini-percutaneous nephrolithotomy for 2-3 cm renal stones.
Article in Therapeutic advances in urology. 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
Background: The optimal management of 2-3 cm renal stones remains challenging because effective stone clearance must be balanced against perioperative morbidity. Mini-percutaneous nephrolithotomy (mPCNL) provides high stone-free rates (SFR) but is associated with greater procedural burden, whereas flexible ureteroscopic lithotripsy (fURL) is less invasive but may be limited by fragment clearance efficiency. A flexible vacuum-assisted ureteral access sheath (FV-UAS) has recently been introduced to facilitate fragment evacuation and improve intrarenal drainage during fURL. Objectives: To compare the efficacy and safety of FV-UAS-assisted fURL, conventional ureteral access sheath-assisted flexible ureteroscopic lithotripsy (UAS-assisted fURL), and mPCNL for the treatment of 2-3 cm renal stones, and to provide evidence for surgical decision-making in this clinical setting. Design: This was a retrospective single-center comparative study. Methods: This retrospective study included 156 patients with 2-3 cm renal stones who underwent FV-UAS-assisted fURL (FV-UAS group, Results: Operative time differed significantly among the three groups (FV-UAS 77.56 ± 15.04 min vs mPCNL 67.60 ± 10.44 min vs UAS 85.04 ± 15.78 min; Conclusion: For 2-3 cm renal stones, FV-UAS-assisted fURL was associated with less hemoglobin decrease, lower postoperative pain, and shorter hospital stay than mPCNL, and showed advantages over UAS-assisted fURL in operative time and hospitalization costs, while achieving a 1-month SFR comparable to mPCNL. FV-UAS-assisted fURL may represent a safe and effective minimally invasive alternative for 2-3 cm renal stones. Trial registration: Not applicable.
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