Endoscopic treatment of children with vesico-ureteric reflux
| Autor: | Nils Wåhlin, Arne Stenberg, Göran Läckgren |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Silicones Biocompatible Materials Injections Prosthesis Implantation medicine Humans Hyaluronic Acid Antibiotic prophylaxis Child Prospective cohort study Polytetrafluoroethylene Vesico-Ureteral Reflux Kidney medicine.diagnostic_test business.industry Reflux Dextrans Endoscopy General Medicine Cystoscopy Surgery Treatment Outcome medicine.anatomical_structure Evaluation Studies as Topic Pediatrics Perinatology and Child Health Urologic Surgical Procedures Dextranomer Collagen business Endoscopic treatment Ureteric reflux medicine.drug |
| Zdroj: | Acta Paediatrica. 88:62-71 |
| ISSN: | 0803-5253 |
| DOI: | 10.1111/j.1651-2227.1999.tb01320.x |
| Popis: | Endoscopic subureteric injection of tissue-augmenting substances has become an alternative to long-term antibiotic prophylaxis and open surgery in the treatment of children with vesico-ureteric reflux. Successful elimination of reflux in about 80% of patients after a single injection (and in 90% after a repeat) has been achieved using the foreign-body non-degradable substances Teflon and silicone. Few patients have required open surgery and recurrence of reflux after initial successful treatment has occurred in only 5-10%. Concern has arisen, however, about possible distant migration and granuloma formation after injection of particulate plastic materials. Cross-linked bovine collagen is a biodegradable alternative substance, but with a lower response rate of 60% after the first treatment and a recurrence rate of 10-20%. Dextranomer in sodium hyaluronan is a new biological substance with microparticles with a response rate of 69% after the first injection. Biological substances have caused few complications. Present literature on injection treatment unfortunately focuses on elimination of reflux, with little attention to subsequent frequency of pyelonephritis or to the long-term development of the kidneys. Furthermore, there are no controlled, randomized studies with subureteric injection as one of the treatment alternatives. Thus, although having the advantage of being a minimally invasive procedure that can be performed on an outpatient basis, this technique needs to be tested in a large prospective study with the long-term renal outcome as the main end-point. |
| Databáze: | OpenAIRE |
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