Department of Paediatric Surgery, Starship Children's Health, Auckland, New Zealand.
Department of Paediatric Surgery, Starship Children's Health, Auckland, New Zealand.
J Pediatr Urol. 2019 Oct;15(5):560.e1-560.e6. doi: 10.1016/j.jpurol.2019.07.002. Epub 2019 Jul 11.
The aim of this study is to evaluate the efficacy of primary cystoscopic transurethral incision (CTUI) in the management of paediatric ureteroceles. The secondary aim is to compare the efficacy of CTUI between simplex and duplex systems.
This is a retrospective review of consecutive paediatric patients requiring surgical intervention for ureterocele. Data collected for analysis included demographics, diagnostic, pre-operative investigations, operative interventions and postoperative variables.
Over a 19-year period, 79 consecutive cases were identified, and 42 were male (53.2%). The mean follow-up was 6.7 years. Seventy-three (92.4%) cases underwent primary CTUI; 50 of these cases (68.5%) required no further procedures during the study period. Sixty-one cases were treated by endoscopic intervention alone (77.2%). Forty-one (51.9%) cases had a simplex system, and 38 (48.1%), a duplex system. There was no statistically significant difference in the efficacy of primary CTUI in simplex vs duplex systems. Of the 20 patients who had pre-operative and postoperative micturating cystourethrograms performed, seven (35%) developed de-novo postoperative vesicoureteric reflux after CTUI.
Primary CTUI is a safe, minimally invasive procedure that is definitive in the majority of children presenting with a ureterocele that requires intervention. There was no difference in success of primary CTUI between simplex or duplex systems.
本研究旨在评估原发性经膀胱镜下经尿道切开术（CTUI）治疗小儿输尿管囊肿的疗效。次要目的是比较单纯性和复杂性系统中 CTUI 的疗效。
这是一项对需要手术干预输尿管囊肿的连续小儿患者进行的回顾性研究。收集用于分析的数据包括人口统计学、诊断、术前检查、手术干预和术后变量。
在 19 年期间，共确定了 79 例连续病例，其中 42 例为男性（53.2%）。平均随访时间为 6.7 年。73 例（92.4%）患者接受了原发性 CTUI；在研究期间，50 例（68.5%）患者无需进一步手术。61 例患者仅接受内镜干预治疗（77.2%）。41 例（51.9%）为单纯性系统，38 例（48.1%）为复杂性系统。单纯性和复杂性系统中原发性 CTUI 的疗效无统计学差异。在 20 例接受术前和术后排尿性膀胱尿道造影的患者中，7 例（35%）在 CTUI 后出现新发性术后膀胱输尿管反流。
原发性 CTUI 是一种安全、微创的方法，对于需要干预的大多数输尿管囊肿患儿是确定性的。单纯性和复杂性系统中原发性 CTUI 的成功率无差异。
