Effectiveness and Safety of Suction-Assisted Technologies in Pediatric Endourological Stone Surgery: A Systematic Review by the EAU-YAU Pediatric Urology Working Group
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Objective: Although new suction/vacuum technologies have been tested in adults in recent years, they remain uncommon in pediatric practice. This systematic review aimed to analyze the existing literature on the effectiveness and safety of new suction technologies for pediatric endourological stone interventions. Materials and Methods: We conducted a systematic review (PROSPERO CRD420261335417) following the PRISMA 2020 and Cochrane guidelines, searching PubMed, Embase, MEDLINE, Web of Science, and Scopus to identify all published reports on new suction/vacuum technologies for pediatric endourological stone interventions through February 2026. The primary outcomes were intraoperative and postoperative complications and stone-free rates (SFRs). Secondary outcomes included operative time, hospital stay, and the need for ancillary procedures. We used the MINORS tool to assess the risk of bias in nonrandomized cohort studies. Results: The review included a total of 367 patients (370 renal units) aged 1-17 years who underwent endourological stone surgery. The vacuum-assisted mini-PCNL group had a higher SFR of 81.3-100% and lower complication and reintervention rates of 0-27.8% and 0-12.5%, respectively, compared with conventional mini-PCNL. Furthermore, a higher SFR of 85.7-100% was observed with RIRS using FANS-UAS compared with an SFR of 60-88% in children who underwent conventional RIRS. The former group also had a lower reintervention rate (0-9.5% vs. 0-40%) and fewer grade III-IV complications (0% vs. 8.7%). Conclusion: Current evidence, although limited and mainly based on observational studies, suggests that suction-assisted technologies may improve stone clearance and maintain acceptable safety profiles in selected pediatric endourological stone interventions. However, the absence of randomized trials, heterogeneous outcome definitions, and limited long-term follow-up prevent definitive conclusions.
Institutions: Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi, Erciyes University, Istanbul University, University of Toronto, Puigvert Foundation, Ospedale dei Bambini Vittore Buzzi, University Medical Center Groningen, University of Patras, Hospital Universitari de Girona Doctor Josep Trueta, Erasmus MC, Erasmus MC - Sophia Children’s Hospital
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7220992764