Luo Daxun, Xu Zheng, Ding Tianfu, Liu Yubao, Li Jianxing
Department of Urology, Beijing Tsinghua Changgung Hospital, Research Center for Urinary Disease, School of Clinical Medicine, Tsinghua University, Beijing, China.
Front Surg. 2025 Jul 22;12:1586882. doi: 10.3389/fsurg.2025.1586882. eCollection 2025.
To compare the flexible and navigable suction ureteral access sheath (FANS) with the conventional ureteral access sheath, both in combination with Needle-perc Assisted Endoscopic Surgery (NAES), for treating <2 cm lower calyceal stones with unfavorable anatomy.
Data of patients admitted to Beijing Tsinghua Changgung Hospital with <2 cm stones with unfavorable anatomy of the renal lower calyx from August 2023 to May 2024 were collected retrospectively, and matched parameters such as age, gender, BMI, stone size, CT values, laboratory tests, and anatomical features of the lower calyces of the kidney were recorded. Both groups of patients were treated with NAES, and patients who were treated with FANS were compared with those who received a conventional ureteral access sheath in a pairwise analysis (1:1). Data were analyzed using -test, Mann-Whitney -test, and chi-square test.
Both groups had similar baseline characteristics. The immediate stone-free rate (SFR) was better in the FANS group than in the conventional ureteral access sheath treatment group (88% vs. 64%, = 0.044). The duration of surgery was shorter in the former than in the latter in both groups (100.75 ± 25.32 min vs. 116.21 ± 35.56 min, = 0.048). No statistically significant differences were observed between the two groups in postoperative ESWL treatment, postoperative creatinine, hospital stay, 1-month SFR, and complication rates.
In the NAES procedure, compared with conventional ureteral access sheath, the FANS ensures safety while also demonstrating greater effectiveness for treating kidney stones in patients with unfavorable renal lower calyx anatomy of less than 2 cm.
比较可弯曲可导航输尿管导入鞘（FANS）与传统输尿管导入鞘在联合针穿辅助内镜手术（NAES）治疗下肾盏结石<2 cm且解剖结构不利的患者中的效果。
回顾性收集2023年8月至2024年5月在北京清华长庚医院收治的肾下盏结石<2 cm且解剖结构不利的患者数据，记录年龄、性别、BMI、结石大小、CT值、实验室检查及肾下盏解剖特征等匹配参数。两组患者均接受NAES治疗，将接受FANS治疗的患者与接受传统输尿管导入鞘治疗的患者进行配对分析（1:1）。数据采用t检验、Mann-Whitney U检验和卡方检验进行分析。
两组患者基线特征相似。FANS组的即刻无石率（SFR）优于传统输尿管导入鞘治疗组（88%对64%，P = 0.044）。两组中，前者的手术时间均短于后者（100.75±25.32分钟对116.21±35.56分钟，P = 0.048）。两组在术后体外冲击波碎石治疗、术后肌酐水平、住院时间、1个月SFR及并发症发生率方面无统计学显著差异。
在NAES手术中，与传统输尿管导入鞘相比，FANS在确保安全性的同时，对于治疗肾下盏解剖结构不利且结石<2 cm的患者，在治疗肾结石方面也显示出更高的有效性。
