A prospective multicenter study of Flexible ureteroscopy using different flexible and navigable suction access sheath (FANS) sizes: peri and 30-day postoperative outcomes from the global and prospective multicenter FLEXible ureteroscopy Outcomes Registry using FANS (FLEXOR-F) by the EAU section of endourology

Gauhar, Vineet; Yuen, Steffi; Somani, Bhaskar; Angerri, Oriol; Demirkiran, Denizhan; Fong, Khi; Petkova, Kremena; Soebhali, Bokye; Parikesit, Dyandra; Sissoko, Idrissa; Rico, Luis; Tzelves, Lazaros; Mazzon, Giorgio; Tsaturyan, Arman; Elshazly, Mohamed; Politi, Estaban; Sytnik, Dmitry; Tefik, Tzevat; Du, Jingzeng; Chong, Tsung; ŞEN, VOLKAN; Aydin, Cemil; Akdogan, Nebil; Tanidir, Yiloren; Geavlete, Petrisor; Traxer, Olivier; Ferretti, Stefania; Castellani, Daniele

doi:10.23736/s2724-6051.26.07004-7

A prospective multicenter study of Flexible ureteroscopy using different flexible and navigable suction access sheath (FANS) sizes: peri and 30-day postoperative outcomes from the global and prospective multicenter FLEXible ureteroscopy Outcomes Registry using FANS (FLEXOR-F) by the EAU section of endourology

Gauhar V., Yuen S. K., Somani B. K., Angerri O., Demirkiran D., Fong K. Y., ...Daha Fazla

MINERVA UROLOGY AND NEPHROLOGY, 2026 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Basım Tarihi: 2026
Doi Numarası: 10.23736/s2724-6051.26.07004-7
Dergi Adı: MINERVA UROLOGY AND NEPHROLOGY
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
Dokuz Eylül Üniversitesi Adresli: Evet

Özet

BACKGROUND: Flexible and Navigable Suction Ureteral Access Sheath (FANS) revolutionized flexible ureteroscopy for stone management. This study assessed outcomes using a standardized FANS classification across different ureteroscope-sheath combinations. METHODS: We prospectively enrolled 862 adult patients from 21 centers (June-September 2025), stratifying patients into three groups: group 1 (ultra-mini: 6.3 Fr scope/<10 Fr FANS, N.=203, 23.5%), group 2 (mini: 7.5-8 Fr scope/10-12 Fr FANS, N.=446, 51.7%), and group 3 (Standard: >8 Fr scope/11-13 or 12-14 Fr FANS, N.=213, 24.7%). Stone-free rate (SFR) was classified on 30-day CT as grade A (zero residual fragment, ZRF), grade B (single RF <= 2mm), grade C (single RF 2.1-4mm), grade D (single/multiple RF>4mm). RESULTS: Age, gender, Body Mass Index, comorbidities and stone volume were similar across all groups. Overall complications occurred in 21.6% of group 3, 5.8% in group 2, and 10.8% in group 1 (P<0.001). Ureteric injury was more frequent in group 3 (15.5%) than groups 1 (2.5%) and 2 (2.2%, P<0.001). On multivariable analysis, group 3 had significantly lower odds of ZRF (OR 0.38, 95% CI 0.23-0.62, P <0.001) compared to group 1. Grades A+B SFR was 86.3%, with ZRF achieved in 76.5% overall. Group 2 demonstrated superior ZRF rates (80.5%) compared to group 1 (77.8%) and group 3 (65.4%, P<0.001). Grade D was significantly higher in group 3 (14.8%) versus group 2 (5.9%) and group 1 (4.4%). CONCLUSIONS: Ultra-mini and mini-FANS demonstrate superior safety profiles and S FRs compared to standard FANS, with mini-FANS achieving optimal outcomes.