[Endoscopic treatment of vesicorenal reflux in children. Review of three years experience and prospects for the future].
Endoscopic injection of teflon paste, used since 1984, represents an alternative to the surgical treatment of vesico-renal reflux. The success rate varies from 75 to 89% after a single injection and from 85 to 95% after two injections, according to the teams. The results are less satisfactory for the high grades and for refluxes on duplicity (25 to 45% failure rate). This technique is particularly attractive in the case of a difficult surgical intervention, notably when a reimplantation has failed, in the case of reflux on neurological bladder, urethral valves or exstrophy. Various causes of failure or relapse are considered. The advantages of the technique are obvious (low morbidity, very short hospital stay) and surgery is always possible in the case of failure. After one or two years, the reflux reappears in 2 to 9% cases. Long term results cannot be assessed as the follow-up period is too brief at the present time. For this reason, and although the endoscopic and surgical findings are reassuring, tolerance to teflon both locally and at a distance requires confirmation and other products such as collagen are now being used.
Dodat
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Service de Chirurgie Pédiatrique, Hôpital Edouard-Herriot, Lyon.
Takvorian
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D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011138:Polytetrafluoroethylene / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D014718:Vesico-Ureteral Reflux / Q000188:drug therapy* / Q000601:surgery
D011138:Polytetrafluoroethylene
Traitement endoscopique du reflux vésico-rénal chez l'enfant. Le point sur trois années d'expérience et perspectives d'avenir.