[Analysis of the failure of endoscopic treatment of vesico-renal reflux in children using injections of teflon and collagen and the preliminary results of injections of Macroplastic].
This study of 785 cases of vesicorenal reflux in 494 children treated endoscopically over a 7-year period was designed to evaluate the results obtained with three products used successively: Teflon, collagen and Macroplastic. Following Teflon injection, despite a 90% short-term success rate, recurrent reflux was subsequently observed in 16.71% of the ureters reviewed. The failure rate was 52.63% after collagen injection and 11.77% after Macroplastic. After one or two injections, complete resolution of reflux was obtained in 48% of children treated with collagen, versus 85.72% with Teflon and 93.33% with Macroplastic. In one half of cases, failure was related to the quality of the product and its modifications after injection. The marked resorption of collagen accounts for the poor results despite the large doses injected. Apart from one case of partial resorption of Teflon paste, the failures with this product were due to lateralisation or secondary elimination of the product from the injection site due to its fluidity. Macroplastic, due to its higher viscosity and absence of retraction, currently provides the best results with doses of less than 0.20 ml in children.
Dodat
H
H
Service de Chirurgie Pédiatrique, Hôpital Edouard-Herriot, Lyon.
Takvorian
P
P
Mure
P Y
PY
Canterino
I
I
Pouillaude
J M
JM
D001002:Anuria / Q000209:etiology; D002648:Child; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000209:etiology; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage / Q000009:adverse effects; D015745:Granuloma, Foreign-Body / Q000209:etiology; D006801:Humans; D007267:Injections; D008297:Male; D011138:Polytetrafluoroethylene / Q000008:administration & dosage / Q000009:adverse effects; D019736:Prostheses and Implants / Q000009:adverse effects; D012008:Recurrence; D012828:Silicones / Q000008:administration & dosage / Q000009:adverse effects; D017211:Treatment Failure; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000209:etiology; D018666:Ureteroscopy; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon; D011138:Polytetrafluoroethylene; D003094:Collagen
Analyse des échecs du traitement endoscopique du reflux vésico-rénal chez l'enfant par injections de téflon ou de collagène et résultats préliminaires des injections de Macroplastique.