Active migration technique in RIRS for 1‐ to 2‐cm middle and upper ureteral stones in a prospective randomized controlled study

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Hauptverfasser: Ping Liang, Qing‐lai Tang, Juan‐juan Mao, Yu‐xin Zhang, Yun‐peng Li, Xing‐zhu Zhou, Rong‐zhen Tao
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Veröffentlicht: Wiley 2026
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author Ping Liang
Qing‐lai Tang
Juan‐juan Mao
Yu‐xin Zhang
Yun‐peng Li
Xing‐zhu Zhou
Rong‐zhen Tao
author_facet Ping Liang
Qing‐lai Tang
Juan‐juan Mao
Yu‐xin Zhang
Yun‐peng Li
Xing‐zhu Zhou
Rong‐zhen Tao
Ping Liang
Qing‐lai Tang
Juan‐juan Mao
Yu‐xin Zhang
Yun‐peng Li
Xing‐zhu Zhou
Rong‐zhen Tao
collection Wiley Open Access
contents Active migration technique in RIRS for 1‐ to 2‐cm middle and upper ureteral stones in a prospective randomized controlled study Ping Liang Qing‐lai Tang Juan‐juan Mao Yu‐xin Zhang Yun‐peng Li Xing‐zhu Zhou Rong‐zhen Tao BJUI Compass Abstract Objective This study aimed to observe the efficacy and safety of the active migration technique and in situ lithotripsy technique in retrograde intrarenal surgery (RIRS) for patients with 1‐ to 2‐cm middle and upper ureteral stones. Patients and Methods Two hundred seven patients were enrolled in the study, of which 103 included in the study group received active migration lithotripsy and 104 included in the control group received in situ lithotripsy. The primary study outcome was the stone‐free rate (SFR) on the first postoperative day. Secondary outcomes included the total SFR 4 weeks postoperatively, operative time, reduction in the haemoglobin levels, the length of postoperative hospital stay, the incidence of ureteral stricture at 3‐month postoperatively and any surgery‐related complications. Results There was no obvious difference between two groups in patients' demographics and preoperative clinical characteristics ( p  > 0.05). The operative time was significantly shorter in the study group than in the control group (57.1 vs. 62.5 min, p  < 0.001). The study group also had significantly higher immediate and total SFRs (81.5% vs. 64.4%, p  = 0.006, 90.3% vs. 77.9%, p  = 0.015, respectively). At 3 months postoperatively, the incidence of ureteral stricture in the study was statistically lower than in the control group (1.0% vs. 6.7%, p  = 0.032). Notablely, the overall complication rate was significantly lower in the study group than in the control group ( p  < 0.001). Conclusions Our study provides evidence that the active migration technique, when combined with flexible and negative suction ureteral access sheath (FANS) in RIRS, results in a higher SFR and a lower complication rate than in situ lithotripsy for treating 1‐ to 2‐cm middle and upper ureteral stones. The protocol for this study has been accepted by the Chinese Clinical Trial Registry (The registration number: ChiCTR2200056402; Date of registration: 03‐06‐2022). 10.1002/bco2.70204 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/bco2.70204
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id wiley_oa_10_1002_bco2_70204
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
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spellingShingle Active migration technique in RIRS for 1‐ to 2‐cm middle and upper ureteral stones in a prospective randomized controlled study
Ping Liang
Qing‐lai Tang
Juan‐juan Mao
Yu‐xin Zhang
Yun‐peng Li
Xing‐zhu Zhou
Rong‐zhen Tao
BJUI Compass
Active migration technique in RIRS for 1‐ to 2‐cm middle and upper ureteral stones in a prospective randomized controlled study Ping Liang Qing‐lai Tang Juan‐juan Mao Yu‐xin Zhang Yun‐peng Li Xing‐zhu Zhou Rong‐zhen Tao BJUI Compass Abstract Objective This study aimed to observe the efficacy and safety of the active migration technique and in situ lithotripsy technique in retrograde intrarenal surgery (RIRS) for patients with 1‐ to 2‐cm middle and upper ureteral stones. Patients and Methods Two hundred seven patients were enrolled in the study, of which 103 included in the study group received active migration lithotripsy and 104 included in the control group received in situ lithotripsy. The primary study outcome was the stone‐free rate (SFR) on the first postoperative day. Secondary outcomes included the total SFR 4 weeks postoperatively, operative time, reduction in the haemoglobin levels, the length of postoperative hospital stay, the incidence of ureteral stricture at 3‐month postoperatively and any surgery‐related complications. Results There was no obvious difference between two groups in patients' demographics and preoperative clinical characteristics ( p  > 0.05). The operative time was significantly shorter in the study group than in the control group (57.1 vs. 62.5 min, p  < 0.001). The study group also had significantly higher immediate and total SFRs (81.5% vs. 64.4%, p  = 0.006, 90.3% vs. 77.9%, p  = 0.015, respectively). At 3 months postoperatively, the incidence of ureteral stricture in the study was statistically lower than in the control group (1.0% vs. 6.7%, p  = 0.032). Notablely, the overall complication rate was significantly lower in the study group than in the control group ( p  < 0.001). Conclusions Our study provides evidence that the active migration technique, when combined with flexible and negative suction ureteral access sheath (FANS) in RIRS, results in a higher SFR and a lower complication rate than in situ lithotripsy for treating 1‐ to 2‐cm middle and upper ureteral stones. The protocol for this study has been accepted by the Chinese Clinical Trial Registry (The registration number: ChiCTR2200056402; Date of registration: 03‐06‐2022). 10.1002/bco2.70204 http://creativecommons.org/licenses/by/4.0/
title Active migration technique in RIRS for 1‐ to 2‐cm middle and upper ureteral stones in a prospective randomized controlled study
topic BJUI Compass
url https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.70204