{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:07:11Z","timestamp":1754161631427,"version":"3.41.2"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the efficacy and safety of minimally invasive percutaneous nephrolithotomy (MPCNL) combined with ureteral access sheath in the treatment of complex kidney stones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy patients with complex kidney stones in the author's hospital from June 2022 to December 2023 were randomized. There were 35 cases of minimally invasive percutaneous nephrolithotomy combined with ureteral access sheath and 35 cases of minimally invasive percutaneous nephrolithotomy alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to the MPCNL group, the MPCNL\u2009+\u2009UAS group demonstrated a significantly shorter operative time (55.4\u2009\u00b1\u20099.2\u2005min vs. 61.5\u2009\u00b1\u200912.8\u2005min, <jats:italic>p<\/jats:italic>\u2009=\u20090.027), significantly lower intraoperative renal pelvic pressure (9.15\u2009\u00b1\u20094.13\u2005mmHg vs. 11.35\u2009\u00b1\u20094.21\u2005mmHg, <jats:italic>p<\/jats:italic>\u2009=\u20090.031), and a significantly lower incidence of postoperative Clavien complications (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05); however, there were no significant differences between the groups in postoperative creatinine change, stone clearance rate at 1 day postoperatively, or stone clearance rate at 30 days postoperatively (<jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Minimally invasive percutaneous nephrolithotomy combined with ureteral access sheath is safe and effective in the treatment of complex kidney stones. Ureteral access sheath can significantly shorten the operation time of minimally invasive PCNL, keep the visual field clear, reduce the pressure of renal pelvis, and reduce the incidence of complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1557603","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T05:21:30Z","timestamp":1753766490000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A clinical study on minimally invasive percutaneous nephrolithotomy combined with ureteral access sheath for the treatment of kidney stones"],"prefix":"10.3389","volume":"12","author":[{"given":"Boyang","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanjie","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yafeng","family":"Shang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1016\/j.juro.2016.05.090","article-title":"Surgical management of stones: american urological association\/endourological society guideline, PART I","volume":"196","author":"Assimos","year":"2016","journal-title":"J Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1080\/20905998.2023.2295041","article-title":"Mini-PCNL\u2014a boon for CKD patients with nephrolithiasis","volume":"22","author":"Ansari","year":"2024","journal-title":"Arab J Urol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.ucl.2021.08.003","article-title":"Mini percutaneous kidney stone removal","volume":"49","author":"Desai","year":"2022","journal-title":"Urol Clin North Am"},{"key":"B4","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s00240-022-01376-5","article-title":"The influencing factors of infectious complications after percutaneous nephrolithotomy: a systematic review and meta-analysis","volume":"51","author":"Zhou","year":"2022","journal-title":"Urolithiasis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.juro.2011.03.029","article-title":"Single-step percutaneous nephrolithotomy (microperc): the initial clinical report","volume":"186","author":"Desai","year":"2011","journal-title":"J Urol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"vid.2020.0025","DOI":"10.1089\/vid.2020.0025","article-title":"Mini-Percutaneous nephrolithotomy technique of percutaneous nephrolithotomy with thulium fiber Laser","volume":"34","author":"Niu","year":"2020","journal-title":"Videourology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1007\/s00345-020-03259-z","article-title":"Characterization of intracalyceal pressure during ureteroscopy","volume":"39","author":"Patel","year":"2021","journal-title":"World J Urol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1089\/end.2015.0171","article-title":"Implementation of ultramini percutaneous nephrolithotomy for treatment of 2\u20133 cm kidney stones: a preliminary report","volume":"29","author":"Shah","year":"2015","journal-title":"J Endourol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"84","DOI":"10.4103\/0970-1591.124213","article-title":"Standardizing the reporting of percutaneous nephrolithotomy complications","volume":"30","author":"Violette","year":"2014","journal-title":"Indian J Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2147","DOI":"10.1089\/end.2008.0001","article-title":"Does a smaller tract in percutaneous nephrolithotomy contribute to high renal pelvic pressure and postoperative fever?","volume":"22","author":"Zhong","year":"2008","journal-title":"J Endourol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1089\/089277902761402989","article-title":"Antibiotic prophylaxis in percutaneous nephrolithotomy: prospective study in 81 patients","volume":"16","author":"Dogan","year":"2002","journal-title":"J Endourol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1007\/s00345-014-1400-8","article-title":"Complications in percutaneous nephrolithotomy","volume":"33","author":"Kyriazis","year":"2015","journal-title":"World J Urol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.ajur.2016.03.001","article-title":"Risk factors for fever and sepsis after percutaneous nephrolithotomy","volume":"3","author":"Rashid","year":"2016","journal-title":"Asian J Urol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.euf.2021.01.010","article-title":"Intrarenal pressure: what is acceptable for flexible ureteroscopy and percutaneous nephrolithotomy?","volume":"7","author":"Doizi","year":"2021","journal-title":"Eur Urol Focus"},{"key":"B15","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s11255-011-0017-8","article-title":"Single-center clinical comparison of two reinforced ureteral access sheaths for retrograde ureteroscopic treatment of urinary lithiasis","volume":"44","author":"Ayyathurai","year":"2012","journal-title":"Int Urol Nephrol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1089\/089277902320913288","article-title":"Laser doppler flowmetric determination of ureteral blood flow after ureteral access sheath placement","volume":"16","author":"Lallas","year":"2002","journal-title":"J Endourol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/S0090-4295(02)02433-0","article-title":"Assessment of stricture formation with the ureteral access sheath","volume":"61","author":"Delvecchio","year":"2003","journal-title":"Urology"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4103\/UA.UA_163_20","article-title":"Does ureteral access sheath have an impact on ureteral injury?","volume":"14","author":"Asutay","year":"2022","journal-title":"Urol Ann"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1557603\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T05:21:30Z","timestamp":1753766490000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1557603\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,29]]},"references-count":18,"alternative-id":["10.3389\/fsurg.2025.1557603"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1557603","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2025,7,29]]},"article-number":"1557603"}}