{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:49:08Z","timestamp":1791805748303,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study retrospectively analyzed 92 patients who underwent negative\u2010pressure suction sheath\u2010assisted flexible ureteroscopic lithotripsy (observation group) and 85 patients who underwent conventional flexible ureteroscopic lithotripsy (control group). Propensity score full matching and weighted analyses were used to balance covariates. Operative time, hospital stay, pain scores, hemoglobin changes, white blood cell counts, neutrophil counts, stone clearance rates, and complications were compared, and predictive models for stone clearance were constructed. The observation group achieved significantly higher stone\u2010free rates at 3\u2009days (69.6% vs. 29.7%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and 1\u2009month (75.0% vs. 34.2%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) postoperatively. Relative to the control group, the observation group had postoperative white blood cell counts closer to normal values (9.25\u2009\u00b1\u20093.26 vs. 10.08\u2009\u00b1\u20093.78,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), with a smaller increase from baseline (0.82\u2009\u00b1\u20094.90 vs. 2.96\u2009\u00b1\u20095.02,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The neutrophil percentage was also lower (0.73\u2009\u00b1\u20090.10 vs. 0.77\u2009\u00b1\u20090.07,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), and visual analogue scale pain score was significantly reduced (2.00\u2009\u00b1\u20090.53 vs. 2.56\u2009\u00b1\u20090.89,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The predictive models achieved areas under the receiver operating characteristic curve of 0.727 (95% confidence interval: 0.616\u20130.839) at 3\u2009days and 0.742 (95% confidence interval: 0.630\u20130.855) at 1\u2009month postoperatively, indicating good discriminatory ability. This study shows that flexible negative\u2010pressure suction sheath\u2010assisted flexible ureteroscopic lithotripsy improves short\u2010 and mid\u2010term stone clearance rates in patients with upper urinary tract stones. The models perform well and may facilitate individualized clinical decision\u2010making.\n                  <\/jats:p>","DOI":"10.1002\/kjm2.70299","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:27:23Z","timestamp":1791804443000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Negative Pressure Suction\u2010Assisted Flexible Ureteroscopy for Upper Urinary Tract Calculi and Construction of a Stone\u2010Free Rate Prediction Model"],"prefix":"10.1002","author":[{"given":"Ren\u2010Hui","family":"Qiu","sequence":"first","affiliation":[{"name":"Department of Urology 900th Hospital of PLA Joint Logistic Support Force  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding\u2010Sheng","family":"He","sequence":"additional","affiliation":[{"name":"Department of Prevention Fuzhou Center for Disease Control and Prevention  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3160-606X","authenticated-orcid":false,"given":"Chun\u2010Yu","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Urology 900th Hospital of PLA Joint Logistic Support Force  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Urology 900th Hospital of PLA Joint Logistic Support Force  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9666-1770","authenticated-orcid":false,"given":"Guo\u2010Zhang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Urology 900th Hospital of PLA Joint Logistic Support Force  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fruro.2025.1705953","article-title":"Global Prevalence of Urolithiasis: A Meta\u2010Analysis Accounting for Methodological Heterogeneity","volume":"5","author":"Vera\u2010Ponce V. J.","year":"2025","journal-title":"Frontiers in Urology"},{"issue":"6","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/j.euf.2025.06.004","article-title":"Cost and Effectiveness of Flexible Ureteroscopy Versus Shockwave Lithotripsy for Urolithiasis: A Systematic Review and Meta\u2010Analysis by the European Association of Urology Endourology Section","volume":"11","author":"Nedbal C.","year":"2025","journal-title":"European Urology Focus"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.eururo.2025.06.001","article-title":"Flexible Ureteroscopy With a Flexible and Navigable Suction Ureteral Access Sheath Versus Mini\u2010Percutaneous Nephrolithotomy for Treatment of 2\u20133 Cm Renal Stones: An International, Multicenter, Randomized, Noninferiority Trial","volume":"89","author":"Zeng G.","year":"2026","journal-title":"European Urology"},{"issue":"6","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.euf.2024.05.010","article-title":"Could Use of a Flexible and Navigable Suction Ureteral Access Sheath be a Potential Game\u2010Changer in Retrograde Intrarenal Surgery? Outcomes at 30\u2009Days From a Large, Prospective, Multicenter, Real\u2010World Study by the European Association of Urology Urolithiasis Section","volume":"10","author":"Gauhar V.","year":"2024","journal-title":"European Urology Focus"},{"issue":"1","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","DOI":"10.1186\/s40001-025-02754-6","article-title":"Development and External Validation of a Nomogram for Predicting Sepsis Following Flexible Ureteroscopy","volume":"30","author":"Liu S. S.","year":"2025","journal-title":"European Journal of Medical Research"},{"issue":"1","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s00345-026-06268-6","article-title":"Efficacy and Safety of Flexible and Navigable Suction Ureteral Access Sheath Combined With Flexible Ureteroscopic Lithotripsy Versus Flexible Ureteroscopic Lithotripsy Alone for Infected Upper Urinary Tract Stones: A Retrospective Cohort Study","volume":"44","author":"Huang Q.","year":"2026","journal-title":"World Journal of Urology"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.urology.2025.01.029","article-title":"Assessment of Outcomes and Anatomical Changes in the Upper Urinary Tract Following Flexible Ureteroscopy With a Flexible and Navigable Suction Ureteral Access Sheath: 3\u2010Month Results From a Multicenter Study","volume":"199","author":"Fong K. Y.","year":"2025","journal-title":"Urology"},{"issue":"1","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12894-025-01799-3","article-title":"Comparison Between Flexible and Navigable Suction Ureteral Access Sheath and Standard Ureteral Access Sheath During Flexible Ureteroscopy for the Management of Kidney Stone: Systematic Review and Meta\u2010Analysis","volume":"25","author":"Alnadhari I.","year":"2025","journal-title":"BMC Urology"},{"issue":"1","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12894-025-01817-4","article-title":"Flexible and Navigable Suction Ureteral Access Sheath Versus Traditional Ureteral Access Sheath for Flexible Ureteroscopy in Renal and Proximal Ureteral Stones: A Meta\u2010Analysis of Efficacy and Safety","volume":"25","author":"Liu Q.","year":"2025","journal-title":"BMC Urology"},{"issue":"8","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1177\/08927790251364285","article-title":"Aspiration Technologies in Flexible Ureteroscopic Urolithiasis Treatment: A Disruptive Concept in Pursuit of a Stone\u2010Free Future","volume":"39","author":"Frangopoulos E.","year":"2025","journal-title":"Journal of Endourology"},{"issue":"1","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1007\/s00345-024-05334-1","article-title":"Pressure Reduction and Suction Characteristics of the New Digital Single Use Flexible Ureteroscope With Suction: An In\u2010Vitro Experimental Study","volume":"42","author":"Ballesta Martinez B.","year":"2024","journal-title":"World Journal of Urology"},{"issue":"1","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-75073-1","article-title":"Analysis of Postoperative Infection Factors of Retrograde Intrarenal Surgery Combined With Negative Pressure Equipment for Renal Stones","volume":"14","author":"Cui D.","year":"2024","journal-title":"Scientific Reports"},{"issue":"1","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","DOI":"10.1007\/s00240-025-01699-z","article-title":"Comparison of Flexible Vacuum\u2010Assisted Ureteral Access Sheath Versus Conventional Sheath Combined With Single\u2010Use Flexible Ureteroscope in the Treatment of Renal Calculi","volume":"53","author":"Xu M.","year":"2025","journal-title":"Urolithiasis"},{"issue":"47","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000045933","article-title":"Flexible Negative Pressure Suction Ureteral Access Sheath Combined With Ureteroscopy in the Treatment of Upper Urinary Tract Calculi: A Meta\u2010Analysis","volume":"104","author":"Duan H.","year":"2025","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.acuroe.2023.06.001","article-title":"Experimental and Clinical Applications and Outcomes of Using Different Forms of Suction in Retrograde Intrarenal Surgery. Results From a Systematic Review","volume":"48","author":"Giulioni C.","year":"2024","journal-title":"Actas Urol\u00f3gicas Espa\u00f1olas (English Edition)"},{"issue":"3","key":"e_1_2_12_17_1","first-page":"S78","article-title":"The Exponential Relationship Between Raised Intrarenal Pressure and Bacteraemia","volume":"137","author":"Hong A.","year":"2026","journal-title":"BJU International"},{"issue":"3","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"406","DOI":"10.5173\/ceju.2025.0120","article-title":"Laser Fibers and Baskets. How Do They Affect Suction and Intrarenal Pressures Using the Novel Single\u2010Use Flexible Direct In\u2010Scope Suction Ureteroscopes?","volume":"78","author":"Tsaturyan A.","year":"2025","journal-title":"Central European Journal of Urology"},{"issue":"1","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s00345-025-05744-9","article-title":"Intrarenal Pressure Management Using Flexible Ureteroscope With Direct in\u2010Scope Suction in Combination With Different Size Ureteral Access Sheaths: An Experimental Ex\u2010Vivo Study","volume":"43","author":"Tsaturyan A.","year":"2025","journal-title":"World Journal of Urology"},{"issue":"1","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1007\/s00345-025-06024-2","article-title":"Head\u2010To\u2010Head Comparison of Novel Suction Technologies in Endourology: Suction Mini\u2010PCNL Versus Flexible Ureteroscopy Using Flexible and Navigable Suction Ureteral Access Sheaths for Renal Stone Management. An EAU\u2010Endourology, Propensity Score\u2010Matched Analysis of 1372 Patients","volume":"43","author":"Cormio A.","year":"2025","journal-title":"World Journal of Urology"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2024.1501464","article-title":"Efficacy and Intrarenal Pressure Analysis of Flexible and Navigable Suction Ureteral Access Sheaths With Flexible Ureteroscopy in Modified Surgical Positions for 2\u20136\u2009Cm Upper Urinary Tract Stones: A Multicenter Retrospective Study","volume":"11","author":"Bai J.","year":"2024","journal-title":"Frontiers in Medicine (Lausanne)"},{"issue":"5","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.21037\/tau-2025-138","article-title":"Impact of Suction Ureteral Access Sheath in Ureteroscopy\/Retrograde Intrarenal Surgery: A Systematic Review and Meta\u2010Analysis","volume":"14","author":"Kayano S.","year":"2025","journal-title":"Translational Andrology and Urology"},{"issue":"3","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4111\/icu.20250071","article-title":"Can Flexible Ureteroscopy Using Flexible and Navigable Suction Ureteral Access Sheath (FANS\u2010UAS) Minimize Postoperative Double J Stent Placement? Results From a Propensity Score\u2010Matched Analysis of 540 Patients of the European Association of Urology Section of Endourology and Global FANS Collaborative Study Group","volume":"66","author":"Castellani D.","year":"2025","journal-title":"Investigative and Clinical Urology"},{"issue":"9","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1007\/s00345-022-04091-3","article-title":"Urologists Are Optimistic Surgeons: Prevalence and Predictors of Discordance Between Intraoperative Stone\u2010Free Rate and Cross\u2010Sectional Imaging Evaluation After Vacuum\u2010Assisted Mini\u2010Percutaneous Nephrolithotomy","volume":"40","author":"Jannello L. M. I.","year":"2022","journal-title":"World Journal of Urology"},{"issue":"4","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1159\/000542944","article-title":"Flexible Vacuum\u2010Assisted Ureteral Access Sheath for Treating Impacted Ureteral Stones","volume":"109","author":"Chen Y.","year":"2025","journal-title":"Urologia Internationalis"},{"issue":"1","key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s00345-025-05510-x","article-title":"Vacuum\u2010Assisted Dedusting Lithotripsy: A Retrospective Comparative Study in High\u2010Risk Patients With Positive Preoperative Urine Cultures","volume":"43","author":"Liang J.","year":"2025","journal-title":"World Journal of Urology"},{"issue":"10","key":"e_1_2_12_27_1","doi-asserted-by":"crossref","DOI":"10.1177\/03000605251386570","article-title":"A Novel Bendable Suction Sheath in Flexible Ureteroscopy for Renal Calculi","volume":"53","author":"Zhao J.","year":"2025","journal-title":"Journal of International Medical Research"},{"issue":"1","key":"e_1_2_12_28_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.eururo.2025.03.011","article-title":"European Association of Urology Guidelines on the Diagnosis and Treatment of Urolithiasis","volume":"88","author":"Skolarikos A.","year":"2025","journal-title":"European Urology"},{"issue":"5","key":"e_1_2_12_29_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.5152\/tud.2023.23142","article-title":"The Prime Time for Flexible Ureteroscopy for Large Renal Stones Is Coming: Is Percutaneous Nephrolithotomy No Longer Needed?","volume":"49","author":"Tonyali S.","year":"2023","journal-title":"Urology Research and Practice"},{"issue":"7","key":"e_1_2_12_30_1","doi-asserted-by":"crossref","first-page":"4320","DOI":"10.1097\/JS9.0000000000001345","article-title":"Recent Advances in the Treatment of Renal Stones Using Flexible Ureteroscopys","volume":"110","author":"He M.","year":"2024","journal-title":"International Journal of Surgery"},{"issue":"10","key":"e_1_2_12_31_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1002\/bco2.408","article-title":"Suction Use in Ureterorenoscopy: A Systematic Review and Meta\u2010Analysis of Comparative Studies","volume":"5","author":"Tzelves L.","year":"2024","journal-title":"BJUI Compass"},{"issue":"1","key":"e_1_2_12_32_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s00345-026-06606-8","article-title":"Flexible Ureteroscopy With a Flexible and Navigable Suction Ureteral Access Sheath Versus Mini\u2010Percutaneous Nephrolithotomy for Renal Stones Larger Than 2 Cm in Patients With a Solitary Kidney: A Propensity Score\u2010Matched and Win Ratio Analysis","volume":"44","author":"Zhong J.","year":"2026","journal-title":"World Journal of Urology"},{"key":"e_1_2_12_33_1","article-title":"First Clinical Application of the Novel 6.3 Fr Disposable Digital Flexible Ureteroscope for Treatment of Lower Calyx Renal Stones in Anticoagulated Patient","volume":"60","author":"Xu X.","year":"2025","journal-title":"Urol. Case Rep. [Internet]"},{"issue":"1","key":"e_1_2_12_34_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12894-025-01775-x","article-title":"Enhanced Stone\u2010Free Rates With Suctioning Ureteral Access Sheath vs. Traditional Sheath in Retrograde Intrarenal Surgery: A Systematic Review and Meta\u2010Analysis","volume":"25","author":"Gon\u00e7alves F. G. A.","year":"2025","journal-title":"BMC Urology"}],"container-title":["The Kaohsiung Journal of Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/kjm2.70299","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/kjm2.70299","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/kjm2.70299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:27:28Z","timestamp":1791804448000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/kjm2.70299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":33,"alternative-id":["10.1002\/kjm2.70299"],"URL":"https:\/\/doi.org\/10.1002\/kjm2.70299","archive":["Portico"],"relation":{},"ISSN":["1607-551X","2410-8650"],"issn-type":[{"value":"1607-551X","type":"print"},{"value":"2410-8650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"2026-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70299"}}