Puri P
National Children's Hospital, Dublin, Ireland.
Lancet. 1990 Jun 2;335(8701):1320-2. doi: 10.1016/0140-6736(90)91197-i.
91 children (143 ureters) with primary vesicoureteric reflux (VUR) treated endoscopically by subureteric injection of 'Polytef' (polytetrafluoroethylene) paste were followed up for 2 to 5 1/2 years. 94% of the patients were treated as day cases. Reflux ceased in 113 (79%) of the 143 ureters after a single injection of polytef paste. 20% of ureters in this series required more than one endoscopic injection of polytef paste to correct reflux. Nearly 80% of the 113 ureters corrected after a single injection of polytef required less than 0.3 ml of paste per ureter to correct reflux. 88% of ureters continue to show absence of reflux 2 to 5 1/2 years after endoscopic correction. More than half of the recurrences were only of grade I or grade II severity and required no treatment. 7 ureters had recurrent grade III or IV reflux and were reinjected without any difficulty. The correction of vesicoureteric reflux by endoscopic injection of polytef paste is an outpatient procedure that requires 15 min of anaesthetic time. It is safe, simple, and effective in correcting all grades of reflux. Best results are obtained when the paste is injected precisely into the floor of the submucosal ureter.
91名患有原发性膀胱输尿管反流（VUR）的儿童（143条输尿管）接受了输尿管下注射“聚四氟乙烯”（聚四氟乙烯）糊剂的内镜治疗，并进行了2至5年半的随访。94%的患者作为日间手术病例进行治疗。在单次注射聚四氟乙烯糊剂后，143条输尿管中的113条（79%）反流停止。该系列中20%的输尿管需要不止一次内镜下注射聚四氟乙烯糊剂来纠正反流。在单次注射聚四氟乙烯后得到纠正的113条输尿管中，近80%每条输尿管纠正反流所需的糊剂少于0.3毫升。内镜纠正后2至5年半，88%的输尿管仍无反流。超过一半的复发仅为I级或II级严重程度，无需治疗。7条输尿管出现III级或IV级复发性反流，再次注射时没有任何困难。通过内镜注射聚四氟乙烯糊剂纠正膀胱输尿管反流是一种门诊手术，需要15分钟的麻醉时间。它在纠正所有等级的反流方面安全、简单且有效。当糊剂精确注射到输尿管黏膜下层底部时可获得最佳效果。
