ReviewEuropean urology open science2026
An Updated Systematic Review, Meta-analysis, and Trial Sequential Analysis of Endoscopic Combined Intrarenal Surgery (ECIRS) versus Percutaneous Nephrolithotomy (PCNL) for Upper Urinary Tract Calculi.
Review in European urology open science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Context: Percutaneous nephrolithotomy (PCNL) remains the gold standard for large intrarenal stones. However, endoscopic combined intrarenal surgery (ECIRS) has emerged as an alternative, offering simultaneous antegrade and retrograde access with enhanced intrarenal visualization. This systematic review and meta-analysis evaluates the comparative outcomes of ECIRS and PCNL, with the aim of synthesizing available evidence on stone-free rates (SFRs), complications, and perioperative variables. Objective: This systematic review and meta-analysis evaluates the comparative outcomes of ECIRS and PCNL, with the aim of synthesizing available evidence on stone-free rates (SFRs), complications, and perioperative variables. Evidence acquisition: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic review was conducted across MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library for studies comparing ECIRS with PCNL for the treatment of upper urinary tract calculi in adult patients. The primary endpoint was SFR; secondary outcomes included length of hospital stay (LOS) and postoperative complications. Statistical analysis was conducted using R version 4.6.0 software. Evidence synthesis: Eighteen studies met inclusion criteria, encompassing 946 patients treated with ECIRS and 1226 with PCNL. Meta-analysis revealed that ECIRS was associated with a lower risk of residual fragments-that is, higher SFR-(risk ratio [RR] = 0.41; 95% confidence interval [CI]: 0.33 to 0.52; Conclusions: The available evidence suggests that ECIRS is associated with better SFRs and fewer major complications compared with PCNL, though these findings are primarily driven by observational data and should be interpreted with caution. These results are consistent with ECIRS being a potentially effective, lower-morbidity option in selected patients, though confirmation in high-quality randomized trials is warranted.
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Registered trials
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