OBJECTIVE: To evaluate the clinical efficacy of retrograde intrarenal stone surgery (RIRS) using the vacuum suction technique for the treatment of upper urinary calculi. METHODS: A comprehensive literature search was conducted across multiple databases, including PubMed, Embase, Sino Med, CNKI, WANFANG DATA, and Cochrane. We included studies comparing vacuum suction RIRS with non-vacuum RIRS. Following the PRISMA guidelines, we performed a meta-analysis of the selected studies. Inclusion criteria were randomized controlled trials (RCTs), case-control studies, and retrospective studies evaluating the efficacy of these techniques. Key outcomes analyzed included operative time, hospitalization duration, stone-free rates, and complication rates. Statistical analyses were conducted using mean differences (MD) for continuous variables and odds ratios (OR) for dichotomous outcomes, with corresponding 95% confidence intervals (CI). RESULTS: Sixteen studies (6 RCTs, 1 case-control study, and 9 retrospective studies) involving a total of 2029 patients were included. Meta-analysis revealed that the vacuum suction technique significantly reduced operative time (MD = - 14.45 min, 95% CI [- 18.45
- 10.44], P <
0.00001) and hospital stay (MD = - 0.54 days, 95% CI [- 0.80
- 0.28], P <
0.00001). In addition, patients in the vacuum suction group had a higher stone-free rate (OR = 3.57, 95% CI [2.57
4.95], P <
0.00001) and lower complication rates, particularly in reducing postoperative fever. CONCLUSION: The application of the vacuum suction technique in RIRS significantly improves clinical outcomes by reducing operative time and hospitalization duration, enhancing stone-free rates, and lowering postoperative complication rates. This technique demonstrates a clear clinical advantage over non-vacuum RIRS and should be considered a preferred option for the management of upper urinary tract stones.