SynthesisInternational journal of surgery (London, England)2025
Comparison of safety and efficacy of negative pressure aspiration assisted retrograde intrarenal surgery and traditional percutaneous nephrolithotomy in the treatment of upper urinary tract stones larger than 2 cm: a systematic review and meta-analysis.
Synthesis in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hybrid endoscopic-robotic approaches for complex upper urinary tract disorders: a systematic review and single-arm meta-analysis.Journal of robotic surgery · 2025Pooled it
- Study on automatic recognition of stone composition in intraoperative endoscopic images-a single center study.The Canadian journal of urology · 2026Article
- Association between intraoperative low renal pelvic pressure time and postoperative infectious complications after percutaneous nephrolithotomy: a single-centre retrospective cohort study.World journal of urology · 2026Article
- Computational fluid dynamics-based flow field simulation and optimization of negative-pressure stone removal: stone size, position, and sheath geometry.Scientific reports · 2026Article
- Comment on 'Comparison of safety and efficacy of negative pressure aspiration assisted retrograde intrarenal surgery and traditional percutaneous nephrolithotomy in the treatment of upper urinary tract stones larger than 2 cm: a systematic review and meta-analysis'.International journal of surgery (London, England) · 2026Article
- Leveraging laboratory biomarkers to predict urosepsis after upper urinary tract stone surgery: an explainable machine learning approach.BMC medical informatics and decision making · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPercutaneous nephrolithotomy (PCNL) is widely regarded as the first-line treatment for upper urinary tract stones larger than 2 cm, as recommended by major urological associations. However, a growing body of research highlights the safety and effectiveness of retrograde intrarenal surgery (RIRS) for managing stones of this size in the upper urinary tract, especially with the advent of suction-assisted techniques in RIRS. This study aims to systematically evaluate the safety and efficacy of negative pressure aspiration-assisted RIRS (NPAA-RIRS) in comparison to traditional PCNL.
methodEligible studies were found by searching the PubMed, Embase, Web of Science and the CNKI databases for relevant reports published until July 2024. Outcome measures included initial and final stone-free rate (SFR), secondary operation, operation time, hemoglobin level reduction, blood transfusion, interventional embolization, postoperative hospital stay, complications. The assessment of publication bias was conducted using a funnel plot. Ten studies from nine articles were included, involving 1259 patients.
resultsNPAA-RIRS group showed lower hemoglobin level reduction (WMD = -1.31, 95% CI [-1.64, -0.99], P < 0.001), less blood transfusion (RR = 0.15, 95% CI [0.05, 0.50], P = 0.002), shorter postoperative hospital stay (WMD: -1.93, 95% CI [-2.54, -1.32], P < 0.001), lower Clavien-Dindo I-II complication rate (RR: 0.51, 95% CI [0.38, 0.67], P < 0.001), and lower overall complication rate (RR = 0.52, 95% CI [0.40, 0.68], P < 0.001) compared to the PCNL group. The PCNL group had shorter operation time (WMD = 0.68, 95% CI [0.22, 1.13], P = 0.003), higher initial SFR (RR = 0.87, 95% CI [0.83, 0.92], P < 0.001), and lower rate of secondary operation (RR = 2.51, 95% CI [1.52, 4.12], P < 0.001) compared to the NPAA-RIRS group. There were no statistically significant differences between the two groups in interventional embolization (RR = 0.28, 95% CI [0.06, 1.33], P = 0.11), final SFR (RR = 0.98, 95% CI [0.94, 1.01], P = 0.740), and Clavien-Dindo III-IV complication rate (RR: 0.65, 95% CI [0.28, 1.51], P = 0.316).
conclusionFor upper urinary tract stones larger than 2 cm, both NPAA-RIRS and PCNL are equally safe and effective, achieving comparable final SFR. NPAA-RIRS offers advantages in terms of reduced complications, whereas PCNL shows benefits in shorter operation times and a lower likelihood of requiring secondary procedures. Clinicians can therefore select the most suitable approach based on individual patient circumstances.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.