ReviewAmerican journal of translational research2026
Network meta-analysis of clinical efficacy and safety of flexible ureteroscopic holmium laser lithotripsy combined with tip-flexible suction ureteral access sheath for kidney stones.
Review in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
3 authors.
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Abstract
backgroundThe tip-flexible suction ureteral access sheath is an innovative device designed to reduce intrarenal pressure and improve stone clearance during flexible ureteroscopy. This network meta-analysis compared its efficacy and safety with traditional ureteral access sheath (T-UAS)-assisted flexible ureteroscopy, mini-percutaneous nephrolithotomy (mini-PCNL), and extracorporeal shock wave lithotripsy (ESWL) for 1-3 cm kidney stones.
methodsPubMed, Web of Science, and Cochrane CENTRAL were searched up to December 2025. We included 18 studies (7 RCTs, 3 prospective, 8 retrospective) with a total of 4,987 patients across all study arms. The primary outcome was 1-month stone-free rate (SFR). A frequentist random-effects network meta-analysis was performed.
resultsFor SFR, SUCRA values were: suction sheath 0.84, mini-PCNL 0.76, traditional UAS 0.31, ESWL 0.07. Suction sheath significantly reduced overall complications (RR=0.35, 95% CI: 0.24-0.50) and postoperative fever (RR=0.35, 95% CI: 0.23-0.52) versus traditional UAS. Operative time did not differ between suction sheath and traditional UAS (MD=-0.31 min, 95% CI: -10.64 to 11.25). Intraoperative blood loss was lower with suction sheath than with PCNL/mPCNL (MD=-3.43 g/L, 95% CI: -5.59 to -1.27). Heterogeneity was low for SFR and complications but high for operative time (I
conclusionsThe tip-flexible suction ureteral access sheath provides a favorable balance of efficacy and safety for 1-3 cm kidney stones, with SFR comparable to mini-PCNL but with significantly fewer complications and less trauma. It may be preferred for stones ≤2 cm and an alternative for 2-3 cm stones in patients unfit for percutaneous surgery.
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