Comparative outcomes of flexible ureterorenoscopy with high-power holmium: YAG laser and flexible, navigable suction access sheath vs mini-percutaneous nephrolithotomy in 2-3 cm kidney stones treatment: a prospective cohort study.

IF 2.3 3区医学 Q3 UROLOGY & NEPHROLOGY

BMC Urology Pub Date : 2026-07-11 DOI:10.1186/s12894-026-02250-x

Muzaffer Tansel Kılınç, Yunus Emre Göger, Ömer Faruk Çavdar, Hakan Hakkı Taşkapu, Mehmet Serkan Özkent

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引用次数: 0

Abstract

Background: In this prospective controlled cohort study, we aimed to compare the safety and efficacy of Retrograde intrarenal surgery (RIRS) combined with high-power holmium:YAG laser and vacuum-assisted, flexible, navigable access sheaths (FANS) vs. mini-percutaneous nephrolithotomy (miniPCNL) in 2-3 cm kidney stones.

Methods: Between June 2022 and June 2024, 60 patients with 2-3 cm in diameter kidney stones, aged 18 years or older, were prospectively included. Patients were classified into two groups based on their decision: RIRS (Group 1) and miniPCNL (Group 2). Patient demographic data, preoperative creatinine, and hemoglobin levels were recorded. Stone-related factors were evaluated using preoperative tomography. Creatinine and hemoglobin values were measured on the first postoperative day. Stone-free status (SFRs) was evaluated on the first postoperative day and at the first month. Hospital stays and complications were assessed. This study was retrospectively registered to ClinicalTrials.gov (ID = NCT07349992) on January 16, 2026.

Results: Patient demographic data, preoperative creatinine levels, hemoglobin levels, and stone-related factors were comparable between the groups. The prestenting rate was higher in Group 1 (16.6%, 95% CI: 3.3-30) than in Group 2 (0%, 95% CI: 0-0, p = 0.02). The operative time and complication rates were comparable between the groups. The fluoroscopy time was lower in Group 1 (p < 0.001). The mean hemoglobin decrease was greater in Group 2 (p < 0.001). Stone-free status was comparable on the first day and first month. Hospital stay was shorter in Group 1 (p < 0.001).

Conclusions: Retrograde intrarenal surgery combined with a high-power holmium:YAG laser and FANS shows comparable outcomes to miniPCNL for 2-3 cm kidney stones, yielding a similar SFRs with lower hemoglobin decrease, shorter hospitalization time, and reduced fluoroscopy exposure. However, increased prestenting rates should be considered.

Trial registration: This study was retrospectively registered to ClinicalTrials.gov (ID = NCT07349992) on January 16, 2026.

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一项前瞻性队列研究：高功率钬：YAG激光和灵活、可导航的吸引通路鞘输尿管镜与微型经皮肾镜取石术治疗2-3 cm肾结石的比较结果

背景：在这项前瞻性对照队列研究中，我们旨在比较逆行肾内手术（RIRS）联合高功率钬激光和真空辅助、灵活、可导航通路鞘（FANS）与微型经皮肾镜取石术（miniPCNL）治疗2-3厘米肾结石的安全性和有效性。方法：在2022年6月至2024年6月期间，前瞻性纳入60例直径2-3 cm的肾结石患者，年龄在18岁及以上。根据患者的决定将患者分为两组：RIRS（1组）和miniPCNL（2组）。记录患者人口统计数据、术前肌酐和血红蛋白水平。术前断层扫描评估结石相关因素。术后第一天测定肌酐和血红蛋白值。术后第一天和第一个月评估无结石状态（SFRs）。评估住院时间和并发症。该研究于2026年1月16日回顾性注册到ClinicalTrials.gov （ID = NCT07349992）。结果：两组患者人口学数据、术前肌酐水平、血红蛋白水平和结石相关因素具有可比性。组1的出现率（16.6%,95% CI: 3.3-30）高于组2 （0%,95% CI: 0-0, p = 0.02）。两组间的手术时间和并发症发生率具有可比性。结论：逆行肾内手术联合高功率钬：YAG激光和FANS治疗2-3 cm肾结石的效果与miniPCNL相当，SFRs相似，血红蛋白下降更低，住院时间更短，透视暴露时间更少。但是，应该考虑提高出诊率。试验注册：本研究于2026年1月16日回顾性注册到ClinicalTrials.gov （ID = NCT07349992）。

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来源期刊

BMC Urology UROLOGY & NEPHROLOGY-

CiteScore

3.20

自引率

0.00%

发文量

177

审稿时长

>12 weeks

期刊介绍： BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology. The journal considers manuscripts in the following broad subject-specific sections of urology: Endourology and technology Epidemiology and health outcomes Pediatric urology Pre-clinical and basic research Reconstructive urology Sexual function and fertility Urological imaging Urological oncology Voiding dysfunction Case reports.