Pediatric Urology Division, Pediatric Surgery Department, Hospital Sant Joan de Déu, University of Barcelona, Passeig Sant Joan de Déu 2, 08950, Barcelona, Spain.
World J Urol. 2023 Oct;41(10):2855-2859. doi: 10.1007/s00345-023-04548-z. Epub 2023 Aug 16.
The aim of our study is to compare long-term outcome of endoscopic treatment of VUR using PPC or Dx/HA.
From October 2014 to April 2017 patients with VUR grades from 3 to 5 that needed endoscopic treatment were eligible for this RCT. Patients were randomized in two groups: PPC and Dx/HA. A VCUG was performed at 6 months; if VUR > 3 was still present a second ET was performed. We included for this long-term follow-up study those patients that were successfully treated at short-term follow-up. At 36 months postoperative VCUG was performed to assess outcome. Success was considered if postoperative VUR grade was 0 at 36 months, and there was no ureteral obstruction.
In the previous study, 60/73 ureters were successfully treated in 36/44 patients, and then we have analyzed 60 ureters in 36 patients. Three patients were lost in long-term follow-up, and then we analyzed 57 ureters in 33 patients divided. PPC group 18 patients (28 ureters); and Dx/HA group 15 patients (29 ureters). After 3 years of follow-up the VCUG showed a success rate of 26/28 of RU in PPC and 26/29 of DX/HA. Two RU in PPC group had ureteral obstruction, and then the successful rate for PPC group dropped to 24/28. The overall successful rate at long-term was 72.7% of the RU in PPC group and 70.3% in Dx/HA group.
PPC and Dx/HA has similar long-term outcome in VUR resolution, but ureteral obstruction could be present at long-term follow-up in PPC group.
本研究旨在比较 PPC 与 Dx/HA 内镜治疗 VUR 的长期疗效。
2014 年 10 月至 2017 年 4 月，患有 3 至 5 级 VUR 需要内镜治疗的患者符合本 RCT 标准。患者随机分为 PPC 组和 Dx/HA 组。术后 6 个月行 VCUG，如果仍存在 VUR>3 级，则行第二次 ET。本长期随访研究纳入短期随访成功治疗的患者。术后 36 个月行 VCUG 评估结果。如果术后 36 个月 VUR 分级为 0，且无输尿管梗阻，则视为成功。
在之前的研究中，44 例患者中的 36 例成功治疗了 60/73 个输尿管，然后我们分析了 36 例患者的 60 个输尿管。3 例患者在长期随访中丢失，然后我们分析了 57 个输尿管，分为 33 例患者。PPC 组 18 例（28 个输尿管）；Dx/HA 组 15 例（29 个输尿管）。3 年后的 VCUG 显示，PPC 组的 28 个 RU 中有 26 个成功，Dx/HA 组的 29 个 RU 中有 26 个成功。PPC 组的 2 个 RU 有输尿管梗阻，然后 PPC 组的成功率降至 24/28。长期来看，PPC 组的 RU 成功率为 72.7%，Dx/HA 组为 70.3%。
PPC 和 Dx/HA 在 VUR 缓解方面具有相似的长期疗效，但在 PPC 组中，输尿管梗阻可能在长期随访中出现。
