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Flexible Ureteroscopy With a Flexible and Navigable Suction Ureteral Access Sheath Versus Mini-Percutaneous Nephrolithotomy for 1-2 cm Lower Pole Kidney Stones
Sponsor: The First Affiliated Hospital of Guangzhou Medical University
Summary
This study, known as the FLAME Trial (Flexible ureteroscopy for Lower pole stones And Mini-pErcutaneous nephrolithotomy), is an international, multicenter, randomized, non-inferiority trial. It aims to compare the effectiveness and safety of flexible ureteroscopy using a flexible and navigable suction ureteral access sheath (FANS) versus mini-percutaneous nephrolithotomy (mini-PCNL) in the treatment of 1-2 cm lower pole kidney stones. A total of 640 eligible adult patients will be enrolled across 20 high-volume urology centers in China, Russia, Turkey, and India. Participants will be randomly assigned to undergo either FANS-assisted flexible ureteroscopy or mini-PCNL. The primary outcome is the immediate stone-free rate (SFR) assessed by non-contrast CT within 72 hours after surgery. Secondary outcomes include SFR at 1 month, operative time, pain score, length of hospital stay, complication rates, and changes in health-related quality of life. The goal of this trial is to determine whether the less invasive FANS-assisted approach is non-inferior to mini-PCNL in terms of efficacy, while potentially offering advantages in postoperative recovery and safety.
Official title: Flexible Ureteroscopy With a Flexible and Navigable Suction Ureteral Access Sheath Versus Mini-Percutaneous Nephrolithotomy for 1-2 cm Lower Pole Renal Stones: an International, Multicenter, Randomized Non-Inferiority Trial (FLAME Trial)
Key Details
Gender
All
Age Range
18 Years - 75 Years
Study Type
INTERVENTIONAL
Enrollment
640
Start Date
2025-08-28
Completion Date
2026-03-31
Last Updated
2025-09-08
Healthy Volunteers
No
Conditions
Interventions
Flexible ureteroscopy with FANS
The FANS with negative-pressure suction, enhancing intrarenal pressure control and fragment evacuation during flexible ureteroscopy.
Mini-percutaneous nephrolithotomy (mini-PCNL)
Mini-PCNL is performed under general anesthesia with less than 20 Fr access tract, using rigid nephroscopy and stone fragmentation under direct visualization. Postoperative drainage is provided via nephrostomy or ureteral stent as per protocol.
Locations (1)
The First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China