Retrograde intrarenal surgery with flexible and navigable suction access sheaths vs mini-percutaneous nephrolithotomy for large upper urinary tract stones: a systematic review and meta-analysis.
Han Jie Lee, Clyve Yaow, Ryan Ian Houe Chong et al.
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In 30 seconds
This systematic review and meta-analysis compared flexible and navigable suction access sheath-assisted retrograde intrarenal surgery (FANS-RIRS) with mini-percutaneous nephrolithotomy (PCNL) for large upper urinary tract stones in 2347 adult patients. The study found that FANS-RIRS had comparable stone-free rates (SFRs) to mini-PCNL (OR 0.90) while demonstrating significantly fewer complications and shorter hospital stays.
Key findings
- FANS-RIRS showed comparable SFRs to mini-PCNL for stones ≥2 cm (OR 0.80).
- FANS-RIRS was associated with significantly fewer overall complications and smaller haemoglobin decline.
- Mini-PCNL had shorter operative times for stones ≥2 cm.
- Ancillary procedure rates were similar between FANS-RIRS and mini-PCNL (OR 1.22).
Why it matters
The findings suggest that FANS-RIRS can be a safe and effective alternative to mini-PCNL for managing large upper urinary tract stones, potentially influencing treatment guidelines and patient management strategies.
What to keep in mind
The study's limitations include a predominance of Asian studies, variability in practice, and the inclusion of non-randomised studies.