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Vacuum-assisted Mini-PCNL versus RIRS with flexible and navigable suction ureteral access sheath for 1-3 cm pediatric
Ming Sheng1, Mei Huang2, Zichi Wu3
1Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Urology, Shufu County People's Hospital, Kashi, Xinjiang, China.
Journal of Pediatric Surgery
|July 18, 2026
Summary
Vacuum-assisted mini-percutaneous nephrolithotomy (VA-mini PCNL) and flexible and navigable suction ureteral access sheath (FANS-RIRS) are effective for pediatric upper urinary tract stones. VA-mini PCNL is more cost-effective, while FANS-RIRS offers a shorter hospital stay.
Area of Science:
- Pediatric Urology
- Endourology
- Nephrolithiasis Management
Background:
- Pediatric upper urinary tract stones require effective and safe treatment options.
- Minimally invasive surgical techniques are preferred for pediatric stone removal.
Purpose of the Study:
- To compare the efficacy and safety of vacuum-assisted mini-percutaneous nephrolithotomy (VA-mini PCNL) and flexible and navigable suction ureteral access sheath (FANS-RIRS) for treating pediatric upper urinary tract stones.
- To evaluate outcomes including stone-free rate, complications, operative time, and healthcare costs.
Main Methods:
- Retrospective study of children under 14 years with 1-3 cm upper urinary tract stones.
- Comparison of VA-mini PCNL (n=37) versus FANS-RIRS (n=23) based on matched demographics and stone characteristics.
- Primary outcomes: stone-free rate (SFR), complications, operative time, hospitalization duration, and cost.
Main Results:
- Similar SFR (97.3% vs. 91.3%) and complication rates (2.7% vs. 4.35%) between VA-mini PCNL and FANS-RIRS.
- VA-mini PCNL had a longer hospital stay (9 vs. 7 days) but lower costs ($1921.50 vs. $2339.68).
- No significant differences in surgical time or impact on renal function (creatinine, BUN).
Conclusions:
- Both VA-mini PCNL and FANS-RIRS are viable and effective treatments for pediatric upper urinary tract stones (1-3 cm).
- VA-mini PCNL demonstrates superior cost-effectiveness.
- FANS-RIRS is associated with a shorter hospital stay.
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