Faculty of Medicine

Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14

Browse

Settings

Subject: search.filters.subject.endoscopic treatment

Search Results

Now showing 1 - 2 of 2
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Comparative retrospective study for surgically treated primary VUR in pediatric patients
    (2023-03)
    ;
    Radmila Mila Mihajlova Ilie
    ;
    Magdalena Gjorik Petrushevska
    ;
    Gani Çeku
    ;
    Introduction Vesicoureteral reflux have incidence of about 1% in pediatric population. It is a very common pediatric condition. Anomalies of the ureter, the dynamics of the bladder, and the anatomy of the ureterovesical junction can lead to abnormal valve mechanisms and vesicoureteral reflux. Aim The purpose of this study is to evaluate the effectiveness of open and endoscopic urethral reimplantation in relation to the severity of the vesicoureteral reflux and renal function. Materials and Methods We retrospectively analyzed 53 children treated for primary vesicoureteral reflux at the Clinic of Pediatric Surgery in Skopje in the period from 2017 to 2020. Endoscopic treatment was done using subureteric Teflon injection “STING” technique. Operative treatment (open procedure) was used in higher grade vesicoureteral reflux (3 or 4). The evaluation of the results of the treatment was done mainly according to the following criteria: reduced grade of reflux, maintaining renal function, absence of urinary infection and postoperative complications. These outcomes were compared between the two techniques. Results and Discussion The endoscopic procedure was shown to be superior for lower grade vesicoureteral reflux. The open procedure is preferable in cases of higher vesicoureteral reflux or after failure with the endoscopic procedure. Conclusion Treatment of vesicoureteral reflux with the endoscopic procedure is always preferable due to fewer days of hospitalization and as a minimally invasive approach. Both procedures proved to be effective in reflux correction, and successfully reduce the occurrence of febrile urinary tract infections.
  • Loading...
    Thumbnail Image
    Some of the metrics are blocked by your 
    consent settings
    Item type:Publication,
    Evaluation of two surgical treatments of primary vesiureteral reflux among children-A 15 years experience
    (Association of medical doctors "Sanamed" Novi Pazar, 2016-06-15)
    ;
    ;
    Petrovski, Pero
    ;
    ;
    Kamiloski, Marjan
    Abstract: Aim: aim of the study was to evaluate the efficiency of two different surgical treatments of vesicoureteral reflux (VUR) on succesfull rate and patient outcome. Methods: Retrospective study on children with primary VUR and their surgical treatment from 1999 to 2014 in the University Clinic for Pediatric Surgery in Skopje. A total of 76 children (114 ureters) with VUR ranging from second to fifth grade were treated surgically, 44 patients (67 ureters) with an open surgical technique and 32 patients (47 ureters) with endoscopic treatment ”STING” procedure. The following parameters were analyzed: duration of the intervention, duration of the hospitalization, the need for antibiotics and analgesic therapy and the need for blood and blood derivatives transfusion. The result of the surgical treatment was also validated. Agood result was considered when reduction of VURby 2 degrees with the endoscopic method or by 3 degrees in the open surgical technique was noticed. Results: Using open surgical technique, patients were hospitalized for an average of 9 days (range from 5 to 13 days). All children received double antibiotic therapy. The need for analgesics lasted for 3 to 4 days. 90% of treated children needed blood and/or blood derivatives transfusion. Success rate with this method was 93.8%. Endoscopic procedure was performed as a one-day surgical procedure. The average duration was 15 minutes. Single, prophylactic dose of antibiotic was ordinated. There was no need for blood and/or blood derivatives transfusion. The overall success of the treatment was about 70%. Conclusion: Open surgical procedure is used for more complicated cases, VUR grade IV-V or by previously failed. Endoscopic, “STING” procedure was commonly used for patients with VUR grade greater than 2, after previously failed conservative treatment, febrile urinary infection despite antibiotic prophylaxis and/or emergence of new scarring in the renal parenchyma. Patient assessment and decision for what method will be used must always be done individually for each child.