Abstract: In recent years, minimally invasive techniques have made significant advancements in the management of upper urinary tract stones and have become the mainstream treatment modality. The core procedures currently routinely performed include extracorporeal shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and flexible ureteroscopy with lithotripsy (FURL). SWL is widely adopted due to its non-invasive advantage; however, its stone-free rate (SFR) can be affected by factors such as stone hardness, anatomical location, and patient body type. FURL (or RIRS) is performed through natural body cavities, resulting in minimal trauma; meanwhile, PCNL demonstrates significant efficiency advantages in managing large stone burdens. Currently, PCNL technology continues to evolve toward minimally invasive (miniaturization) and precision-oriented approaches. Concurrently, FURL technology has achieved significant breakthroughs through the integration of key innovations such as intelligent pressure control systems and flexible negative pressure suction sheaths. Therefore, systematically reviewing the latest advancements in minimally invasive surgical treatments for upper urinary tract stones and objectively evaluating their efficacy based on evidence-based medicine (such as comparing the clinical efficacy of PCNL versus FURL combined with novel negative pressure devices) will provide valuable practical guidance for clinicians in developing individualized and optimized treatment plans. Keywords: extracorporeal shock wave lithotripsy, flexible ureteroscope lithotripsy, percutaneous nephrolithotomy
Tong et al. (Sun,) studied this question.