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<p>To evaluate the safety and efficacy of the tip-flexible negative pressure suction ureteral access sheath (FUAS) in retrograde intrarenal surgery (RIRS) for pediatric patients with renal calculi, a retrospective analysis was performed on clinical data of 75 pediatric patients (aged 2–14 years) with renal calculi who underwent RIRS at Hetian County People’s Hospital from January 2023 to August 2025. After 1-month preoperative double-J stent placement, patients were allocated to the FUAS group (<i>n</i> = 25) or conventional UAS (CUAS) group (<i>n</i> = 50), with groups matched for age, stone characteristics, and sheath size (10/12F). Indicators including operation time, stone basket utilization, complications, postoperative hospital stay, and stone clearance were compared. Baseline data were balanced between groups (<i>P</i> &gt; 0.05). The FUAS group had shorter operation time than the CUAS group [(48.6 ± 19.8) min vs. (69.2 ± 22.1) min, <i>P</i> &lt; 0.001], a significantly lower proportion of stone basket usage [32.0% (8 cases) vs. 72.0% (36 cases), <i>P</i> &lt; 0.001], lower postoperative fever incidence (4.0% vs.12.0%, <i>P</i> &lt; 0.05), and shorter postoperative hospital stay [(2.2 ± 0.8) d vs. (3.8 ± 1.1) d, <i>P</i> &lt; 0.001]. Overall complication rates were comparable (12.0% vs.20.0%, <i>P</i> = 0.531), with all complications classified as Clavien-Dindo grade I-II, and stone-free rates showed no significant difference (96.0% vs.88.0%, <i>P</i> = 0.214). In the preschool subgroup (2–6 years, FUAS <i>n</i> = 8 vs. CUAS <i>n</i> = 12), the FUAS group also exhibited advantages: shorter operation time [(46.9 ± 17.8) min vs. (74.1 ± 21.3) min, <i>P</i> = 0.008], lower stone basket usage (25.0% vs. 83.3%, <i>P</i> = 0.005), shorter postoperative hospital stay [(2.3 ± 0.7) d vs. (3.6 ± 1.0) d, <i>P</i> = 0.006], and a 100% stone-free rate (vs. 83.3% in the CUAS group, <i>P</i> = 0.236). In conclusion, RIRS using a 7.5&#xa0;F disposable flexible ureterorenoscope with 10/12F FUAS shows significant advantages for pediatric renal calculi management in Hotan County, with only mild complications. It significantly shortens operation time and postoperative hospital stay, lowers postoperative fever, and is worthy of promotion in urological centers equipped with proper instruments and experienced surgeons.</p>

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Comparison of tip-flexible negative pressure suction sheath and conventional sheath in pediatric renal calculi RIRS: the Hotan experience

  • 期刊论文

  • 发表日期：

    2025年10月13日

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  • Fangming Wang,
  • Yuzhe Tang,
  • Bo Xiao,
  • Shawuti Abudulikemu,
  • Jianxing Li

摘要

To evaluate the safety and efficacy of the tip-flexible negative pressure suction ureteral access sheath (FUAS) in retrograde intrarenal surgery (RIRS) for pediatric patients with renal calculi, a retrospective analysis was performed on clinical data of 75 pediatric patients (aged 2–14 years) with renal calculi who underwent RIRS at Hetian County People’s Hospital from January 2023 to August 2025. After 1-month preoperative double-J stent placement, patients were allocated to the FUAS group (n = 25) or conventional UAS (CUAS) group (n = 50), with groups matched for age, stone characteristics, and sheath size (10/12F). Indicators including operation time, stone basket utilization, complications, postoperative hospital stay, and stone clearance were compared. Baseline data were balanced between groups (P > 0.05). The FUAS group had shorter operation time than the CUAS group [(48.6 ± 19.8) min vs. (69.2 ± 22.1) min, P < 0.001], a significantly lower proportion of stone basket usage [32.0% (8 cases) vs. 72.0% (36 cases), P < 0.001], lower postoperative fever incidence (4.0% vs.12.0%, P < 0.05), and shorter postoperative hospital stay [(2.2 ± 0.8) d vs. (3.8 ± 1.1) d, P < 0.001]. Overall complication rates were comparable (12.0% vs.20.0%, P = 0.531), with all complications classified as Clavien-Dindo grade I-II, and stone-free rates showed no significant difference (96.0% vs.88.0%, P = 0.214). In the preschool subgroup (2–6 years, FUAS n = 8 vs. CUAS n = 12), the FUAS group also exhibited advantages: shorter operation time [(46.9 ± 17.8) min vs. (74.1 ± 21.3) min, P = 0.008], lower stone basket usage (25.0% vs. 83.3%, P = 0.005), shorter postoperative hospital stay [(2.3 ± 0.7) d vs. (3.6 ± 1.0) d, P = 0.006], and a 100% stone-free rate (vs. 83.3% in the CUAS group, P = 0.236). In conclusion, RIRS using a 7.5 F disposable flexible ureterorenoscope with 10/12F FUAS shows significant advantages for pediatric renal calculi management in Hotan County, with only mild complications. It significantly shortens operation time and postoperative hospital stay, lowers postoperative fever, and is worthy of promotion in urological centers equipped with proper instruments and experienced surgeons.