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手术结果:儿童国际反流研究——美国分部

Surgical results: International Reflux Study in Children--United States branch.

作者信息

Duckett J W, Walker R D, Weiss R

机构信息

Division of Urology, Children's Hospital of Philadelphia.

出版信息

J Urol. 1992 Nov;148(5 Pt 2):1674-5. doi: 10.1016/s0022-5347(17)36999-9.

Abstract

A total of 87 patients in the United States underwent surgical correction of vesicoureteral reflux as part of the International Reflux Study in Children. Of the 66 patients randomized to surgical treatment 2 were transferred to the medical group before surgery was performed, while 23 patients originally assigned to receive medical management ultimately underwent surgery. Of the patients 17 (20%) were less than 1 year old, while the remaining children were evenly distributed by age in 2-year intervals up to age 9 years. Reimplantation was performed by the Cohen technique in 52% and by the Politano-Leadbetter technique in 28% of the patients. Bilateral reimplantation was done in 70 patients (80%). The results were satisfactory, with no obstructions. In 81% of the patients average followup was 3.9 years, although followup of less than 1 year in 19% was satisfactory to determine obstruction. Only 3% of the children were lost to followup. Postoperative reflux, which was noted in 5 patients, resolved in all but 1 ureter. These results reflect the experience of senior surgeons in pediatric urology.

摘要

在美国,共有87例患者接受了膀胱输尿管反流的手术矫正,这是国际儿童反流研究的一部分。在随机分配到手术治疗的66例患者中,有2例在手术前转至保守治疗组,而最初分配接受保守治疗的23例患者最终接受了手术。患者中,17例(20%)年龄小于1岁,其余儿童按年龄以2年为间隔均匀分布,直至9岁。52%的患者采用科恩技术进行再植,28%的患者采用波利塔诺 - 利德贝特技术进行再植。70例患者(80%)进行了双侧再植。结果令人满意,无梗阻发生。81%的患者平均随访3.9年,尽管19%的患者随访时间不足1年,但对于确定梗阻情况而言结果也是令人满意的。只有3%的儿童失访。5例患者术后出现反流,除1条输尿管外,其余均已缓解。这些结果反映了小儿泌尿外科资深外科医生的经验。

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