Reunanen M
Department of Pediatric Surgery, Turku University Central Hospital, Finland.
J Urol. 1995 Dec;154(6):2156-8.
The aim of our prospective study was to evaluate the long-term results of correction of vesicoureteral reflux in children by subureteral submucosal endoscopic collagen injection.
Between May 1988 and June 1994, 197 refluxing ureters in 148 children (grade III or IV, international grading system) were treated by collagen injection. Injection was done using general anesthesia and repeated 1 or 2 times if reflux persisted on the 1-month followup radionuclide cystogram. Cystography was repeated at 6 months, 2 years and 4 years.
After 1 month, 6 months, 2 years and 4 years grades III and IV reflux were cured in 93.9%, 91.7%, 85.3% and 81.8%, respectively, of 132 simple ureters. For the 27 duplex ureters success rates were 44.4%, 25.9%, 23.1% and 21.4%, respectively, after 1 month, 6 months, 2 years and 4 years. After failed injections neo-implantation was performed with no difficulty.
Our results show that in simple ureters reflux, especially grade III, can be corrected by collagen injection. Results seem to be stable after 2 years of followup.
我们这项前瞻性研究的目的是评估输尿管黏膜下内镜注射胶原蛋白治疗儿童膀胱输尿管反流的长期效果。
1988年5月至1994年6月，对148例儿童（国际分级系统III级或IV级）的197条反流输尿管进行了胶原蛋白注射治疗。注射在全身麻醉下进行，若1个月随访放射性核素膀胱造影显示反流持续存在，则重复注射1或2次。在6个月、2年和4年时重复进行膀胱造影。
132条单纯输尿管在1个月、6个月、2年和4年后，III级和IV级反流的治愈率分别为93.9%、91.7%、85.3%和81.8%。27条重复输尿管在1个月、6个月、2年和4年后的成功率分别为44.4%、25.9%、23.1%和21.4%。注射失败后进行再植手术没有困难。
我们的结果表明，对于单纯输尿管反流，尤其是III级反流，胶原蛋白注射可以纠正。随访2年后结果似乎稳定。
