{
  "abstract": "Background/Objectives: Micro-percutaneous nephrolithotomy (micro-PCNL) offers direct access to lower pole stones but has limited fragment evacuation. Vacuum-assisted micro-endoscopic combined intrarenal surgery (micro-ECIRS) adds flexible ureteroscopy and suction. We evaluated outcomes after institutional adoption of this technique for symptomatic 1–2 cm lower pole stones. Methods: This retrospective non-concurrent cohort included 81 consecutive adults treated between January 2016 and July 2025 (micro-ECIRS, n = 42; micro-PCNL, n = 39). Only micro-PCNL procedures (n = 33) preceded January 2021. One-month low-dose noncontrast computed tomography (earlier, pre-intervention, in four patients) classified outcomes as Grade A (no residual fragment), Grade B (none >2 mm), or Grade C (none >4 mm; main outcome). Comparisons were unadjusted. Results: Grade C was attained in 90.5% (micro-ECIRS) versus 64.1% (micro-PCNL) (absolute difference 26.4 percentage points, 95% confidence interval [CI] 8.2–43.1; risk ratio [RR] 1.41, 95% CI 1.09–1.82; p = 0.007) and Grade B in 71.4% versus 46.2% (p = 0.025). Grade A did not differ significantly (42.9% vs. 28.2%; p = 0.246). Secondary puncture (4.8% vs. 28.2%) and auxiliary procedures (4.8% vs. 25.6%) were less frequent after micro-ECIRS (both p < 0.05). Complications did not differ significantly (11.9% vs. 30.8%; p = 0.055). Conclusions: In this retrospective, predominantly non-concurrent cohort, institutional adoption of vacuum-assisted micro-ECIRS was associated with higher rates of no residual fragment larger than 2 mm or 4 mm and fewer additional punctures and subsequent procedures. A difference in complete stone clearance was not demonstrated. Treatment–era confounding, baseline imbalance, and complete-case selection prevent causal attribution to the technique.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Urology, Kayseri City Hospital, 38080 Kayseri, Türkiye",
    "Department of Urology, Kayseri Faculty of Medicine, University of Health Sciences, 38080 Kayseri, Türkiye"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hüseyin Biçer",
      "orcid": "0000-0001-7703-3618"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Abdullah Gölbaşı"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Burak Elmaağaç",
      "orcid": "0000-0001-5853-0256"
    },
    {
      "affs": [
        0
      ],
      "name": "Ali Yasin Özercan",
      "orcid": "0000-0001-8378-0409"
    },
    {
      "affs": [
        0
      ],
      "name": "Hasan Oruç Eroğlu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Mert Ali Karadağ",
      "orcid": "0000-0002-2454-8850"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/89cnwjx1v5h6w.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218534",
  "fulltext_url": null,
  "id": "89cnwjx1v5h6w",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8534",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-02",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/89cnwjx1v5h6w.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:21:42Z",
      "native_id": "10.3390/jcm15218534",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8534"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Outcomes Following Institutional Adoption of Vacuum-Assisted Micro-ECIRS for Symptomatic 1–2 cm Lower Pole Renal Stones: A Retrospective Non-Concurrent Cohort Study",
  "title_text": "Outcomes Following Institutional Adoption of Vacuum-Assisted Micro-ECIRS for Symptomatic 1–2 cm Lower Pole Renal Stones: A Retrospective Non-Concurrent Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T00:21:25Z",
  "url": "https://research.draconitic.com/paper/89cnwjx1v5h6w",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}