Tratamiento endoscópico con deflux en reflujo vesicoureteral
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Rev. bol. ped.
Abstract
Introducción: el tratamiento del reflujo vesicoureteral (RVU) ha pasado por varias etapas, desde la conducta clínica hasta la quirúrgica. La aplicación endoscópica de substancias a nivel del meato ureteral con buenos resultados en otros centros, motivó a introducir este tratamiento en busca de una alternativa menos invasiva y segura para la resolución del RVU. Propósito: en el presente estudio se revisan los resultados obtenidos con la aplicación de Delux (copolimero de dextranomero en acido hialurónico) en pacientes con distintos grados de RVU, en el Hospital Universitario Japonés de Santa Cruz de la Sierra. Método: se analizaron 7 pacientes con RVU con sistemas únicos, siendo un total de 13 uréteres con RVU de I a IV grado, afectándose el 53% izquierdo y el 47% derecho, a los cuales se inyectó Deflux en el periodo de Septiembre del 2007 a Abril del 2008. Se realizó ecografía de vías urinarias de control a los treinta días y uretrocistografía de control a los tres mese pos inyección. Resultados: 71% de los pacientes pertenecían al sexo femenino, con edades comprendidas entre 1 año/5 meses y 5 años/6 meses. La resolución de los casos fue del 85% con una aplicación y el 90% con dos aplicaciones. Grados I y II tuvieron una resolución del el 100% con una aplicación. A mayor grado de RVU, fue menor el porcentaje de resolución y mayor la necesidad de una segunda aplicación. Todos los pacientes fueron manejados en forma ambulatoria. Conclusiones: la aplicación de Deflux es una excelente alternativa para el tratamiento del relujo vesicoureteral.
Background: the treatment of vesicoureteral reflux (VUR) has gone through several stages, from the clinic to the surgical management. The implementation of endoscopic substances at the ureteral meatus which was successful in other centers, prompted us to introduce this treatment in search of a safe and less invasive alternative to the resolution of VUR. Purpose: this study reviewed the results achieved with the implementation of Delux (copolymer of dextranomer in hyaluronic acid) in patients with varying degrees of VUR. At the Japanese University Hospital of Santa Cruz de la Sierra. Method: we studied to 7 patients with VUR with unique systems, with a total of 13 ureters with VUR grade I to IV, affecting 53% and 47% left-right side respectively, in which Delux was injected in the period September 2007 through April 2008. We urinary tract control through ultrasound within thirty days and voiding cistourethrography control within three months after the injection. Results: 71% of patients were females, aged 1 year 5 months to 5 years and 6 months with an average of 2 years 6 months. The disposition of cases was 85% with an application and 90% with two applications. Grades I and II had a resolution of 100% with one application. A greater degree of VUR, the lower the percentage of resolution and greater need for a second application. All patients underwent surgery in outpatient placement with a mean of 5 hours. Conclusions: the use of Deflux is an excellent alternative for treating Vesicoureteral relux.
Background: the treatment of vesicoureteral reflux (VUR) has gone through several stages, from the clinic to the surgical management. The implementation of endoscopic substances at the ureteral meatus which was successful in other centers, prompted us to introduce this treatment in search of a safe and less invasive alternative to the resolution of VUR. Purpose: this study reviewed the results achieved with the implementation of Delux (copolymer of dextranomer in hyaluronic acid) in patients with varying degrees of VUR. At the Japanese University Hospital of Santa Cruz de la Sierra. Method: we studied to 7 patients with VUR with unique systems, with a total of 13 ureters with VUR grade I to IV, affecting 53% and 47% left-right side respectively, in which Delux was injected in the period September 2007 through April 2008. We urinary tract control through ultrasound within thirty days and voiding cistourethrography control within three months after the injection. Results: 71% of patients were females, aged 1 year 5 months to 5 years and 6 months with an average of 2 years 6 months. The disposition of cases was 85% with an application and 90% with two applications. Grades I and II had a resolution of 100% with one application. A greater degree of VUR, the lower the percentage of resolution and greater need for a second application. All patients underwent surgery in outpatient placement with a mean of 5 hours. Conclusions: the use of Deflux is an excellent alternative for treating Vesicoureteral relux.
Description
Vol. 48, No. 1