Evaluation of two surgical treatments of primary vesiureteral reflux among children-A 15 years experience
Journal
Sanamed
Date Issued
2016-06-15
Author(s)
Petrovski, Pero
Kamiloski, Marjan
Ziberi, Jetmir
Mihajlova, Mila
Abstract
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.
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.
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