Cui Deheng, Ma Qinghong, Wang Guangzhi, Luo Jianbin, Chen Guoqiang
Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China.
BMC Infect Dis. 2025 Aug 28;25(1):1079. doi: 10.1186/s12879-025-11508-y.
To compare the safety and efficacy of flexible and navigable suction (FANS) ureteral access sheath-assisted retrograde intrarenal surgery (FANS-RIRS) for infectious versus non-infectious stones.
A retrospective study of 274 patients treated with FANS-RIRS (November 2023–December 2024). Patients were stratified postoperatively into groups based on stone composition. The infectious stone group ( = 61) comprised stones containing at least one of the following components: magnesium ammonium phosphate hexahydrate (struvite), carbonate apatite, or ammonium urate, either as pure or mixed compositions. The non-infectious stone group ( = 213) included other stone types such as metabolic stones, those associated with genetic abnormalities, and drug-induced stones. Outcomes included infectious complications (SIRS/sepsis), stone-free rate (SFR), operative time, and postoperative complications. Statistical analysis used t-tests, Mann-Whitney U, and chi-square tests.
No sepsis occurred in either group. Immediate SFR was comparable (90.2% vs. 92.1%, = 0.638), with residual stones in infectious cases primarily in lower-pole calyces or diverticula. Infectious stones showed higher preoperative urine culture positivity (32.8% vs. 20.6%, = 0.046), but no differences in operative time, hospital stay, or complications.
FANS-RIRS for infectious stones demonstrated comparable postoperative infection rates to non-infectious stones, proving safe and effective. However, postoperative antimicrobial stewardship and regular surveillance remained paramount for infectious stone management.
比较可弯曲可导航吸引（FANS）输尿管通路鞘辅助逆行肾内手术（FANS-RIRS）治疗感染性结石与非感染性结石的安全性和有效性。
对274例接受FANS-RIRS治疗的患者（2023年11月至2024年12月）进行回顾性研究。术后根据结石成分将患者分层分组。感染性结石组（n = 61）包括含有以下至少一种成分的结石：六水磷酸镁铵（鸟粪石）、碳酸磷灰石或尿酸铵，可为纯成分或混合成分。非感染性结石组（n = 213）包括其他类型的结石，如代谢性结石、与基因异常相关的结石和药物性结石。观察指标包括感染并发症（全身炎症反应综合征/脓毒症）、结石清除率（SFR）、手术时间和术后并发症。采用t检验、Mann-Whitney U检验和卡方检验进行统计学分析。
两组均未发生脓毒症。即刻结石清除率相当（90.2%对92.1%，P = 0.638），感染性病例中的残留结石主要位于下极肾盏或憩室。感染性结石术前尿培养阳性率较高（32.8%对20.6%，P = 0.046），但手术时间、住院时间或并发症方面无差异。
FANS-RIRS治疗感染性结石的术后感染率与非感染性结石相当，证明其安全有效。然而，术后抗菌管理和定期监测对于感染性结石的管理仍然至关重要。
