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Background <p>Urinary tract calculi are highly prevalent worldwide. Vacuum-Assisted Dedusting Lithotripsy (VADL) integrates a Flexible and Navigable suction ureteral access Sheath (FANS) with active suction to overcome limitations of traditional methods.</p> Methods <p>This retrospective cohort study analyzed 1267 patients with renal/proximal ureteral calculi (stratified by stone size: ≤ 2&#xa0;cm, 2–3&#xa0;cm, &gt; 3&#xa0;cm) treated with VADL (2022–2024). Primary outcomes were stone-free rate (SFR) and complications.</p> Results <p>Overall 3-month SFR was 79.34% (941/1186), highest in ≤ 2&#xa0;cm group (85.96%, OR = 3.2, 95%CI 2.1–4.8). Clavien-Dindo ≥ III complications occurred in 0.34%. Ureteral injury (≥ Grade 2) was 9.61%, associated with sheath size (12/14F: 15.53% vs. 10/12F: 6.63%, P = 0.01).</p> Conclusions <p>VADL achieves high SFR with minimal severe complications, particularly for stones ≤ 2&#xa0;cm.</p> Graphical Abstract <p></p>

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Vacuum-assisted dedusting lithotripsy (VADL) using flexible and navigable suction ureteral access sheath (FANS) achieves high stone-free rates with low infection in renal and proximal ureteral calculi: A retrospective cohort study of 1267 cases

  • 期刊论文

  • 发表日期：

    2025年10月17日

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  • Qi Liu,
  • Xuanhao Zhang,
  • Jian Li,
  • Junkai Huang,
  • Haijie Xie,
  • Liwei Liu

摘要

Background

Urinary tract calculi are highly prevalent worldwide. Vacuum-Assisted Dedusting Lithotripsy (VADL) integrates a Flexible and Navigable suction ureteral access Sheath (FANS) with active suction to overcome limitations of traditional methods.

Methods

This retrospective cohort study analyzed 1267 patients with renal/proximal ureteral calculi (stratified by stone size: ≤ 2 cm, 2–3 cm, > 3 cm) treated with VADL (2022–2024). Primary outcomes were stone-free rate (SFR) and complications.

Results

Overall 3-month SFR was 79.34% (941/1186), highest in ≤ 2 cm group (85.96%, OR = 3.2, 95%CI 2.1–4.8). Clavien-Dindo ≥ III complications occurred in 0.34%. Ureteral injury (≥ Grade 2) was 9.61%, associated with sheath size (12/14F: 15.53% vs. 10/12F: 6.63%, P = 0.01).

Conclusions

VADL achieves high SFR with minimal severe complications, particularly for stones ≤ 2 cm.

Graphical Abstract