SYSTEMATIC REVIEW article
Front. Surg.
Sec. Genitourinary Surgery and Interventions
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1649574
Efficacy and Safety of Flexible negative-pressure ureteral sheath in Retrograde Intrarenal Surgery (RIRS): A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Chengdu University, Chengdu, China
- 2Chengdu Qingbaijiang District People's Hospital, Chengdu, China
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AbstractPurpose: To evaluate the safety and efficacy of flexible negative-pressure ureteral sheaths in flexible ureteroscopic lithotripsy (RIRS) for urinary calculi.Methods: Computerized searches were performed in English databases including PubMed, Embase, Web of Science, and the Cochrane Library up to February 4, 2025, to identify clinical studies on flexible negative-pressure ureteral sheaths（FANS） combined with RIRS for urinary calculi. Data analysis and extraction were conducted using Stata 18.0 and Review Manager 5.3 software.Results: This meta-analysis of 9 studies (1,785 patients) showed FANS significantly improved stone-free rates (OR=2.58, 95%CI=2.11–3.15) and reduced intraoperative (OR=0.32, P=0.02), postoperative (OR=0.37), reoperation (OR=0.28), and stone basket use (OR=0.01) vs traditional ureteral access sheaths (T-UAS). Subgroup analyses confirmed FANS superiority for stones ≤20 mm (OR=2.10) and >20 mm (OR=3.03), with shorter operative times for small stones (SMD=−0.31) and Ho:YAG (SMD=−0.63).Conclusions: FANS enhances RIRS efficacy and safety by improving stone clearance, reducing complications, and minimizing auxiliary instrument use. While it did not shorten hospitalization or overall operative time, its advantages for larger stones and laser compatibility underscore clinical value.
Keywords: Flexible and navigable suction, Retrograde intrarenal surgery, Urinary Calculi, Renal calculi, Meta-analysis.
Received: 18 Jun 2025; Accepted: 11 Jul 2025.
Copyright: © 2025 WANG, Luo, Huang and Jia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qilei Jia, Chengdu Qingbaijiang District People's Hospital, Chengdu, China
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