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  1. Gauhar V, Traxer O, Yuen SKK, Castellani D, Zeng G, Fong KY, et al.
    World J Urol, 2025 Mar 21;43(1):184.
    PMID: 40119185 DOI: 10.1007/s00345-025-05570-z
    BACKGROUND: Flexible and navigable suction ureteral access sheath (FANS) has been proven to improve stone-free rate (SFR) and many studies report high intraoperative 100% stone-free status (IO-SFS) and postoperative 100% stone-free status (PO-SFS). The reliability of IO-SFS vis-à-vis image-proven PO-SFS needs to be evaluated as it has implications on perioperative management.

    METHODS: Our prospective, multicenter study enrolled 704 adult patients from 21 centers who underwent FURS with FANS between August 2023 and October 2024. IO-SFS was categorized into three groups: (1) 100% SFR (no dust or fragments), (2) only dust remaining, and (3) both dust and fragments remaining. PO-SFS was assessed via 2 mm non-contrast computed tomography (NCCT) at 30 days and categorized into four grades: Grade A (100% stone-free), Grade B (single ≤ 2 mm residual fragment), Grade C (single 2.1-4 mm), and Grade D (multiple or any > 4 mm). Primary outcome was correlation between intraoperative and postoperative 100% SFS. Secondary outcomes included perioperative complications, reintervention rates, and predictors of residual fragments and perioperative complications.

    RESULTS: IO-SFS reported 100% SFR in 395 cases. Postoperative NCCT confirmed a significantly higher SFS (Grade A + B) in this group (99%) compared to 95.8% in the dust only group and 61.1% in the dust and fragments group (p 

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