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[Immediate and late results of anti-reflux surgery in children]
Insights
The study analyzed 114 antireflux operations in children, finding that surgical method and bladder function impact outcomes. Politano-Leadbetter and Kohen techniques showed the best results for preventing reflux.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Vesicoureteral Reflux
Context:
- Vesicoureteral reflux (VUR) affects numerous children, necessitating surgical intervention.
- Evaluating the long-term efficacy of different antireflux procedures is crucial for pediatric urological practice.
- 114 antireflux operations in 78 children were reviewed to assess surgical outcomes.
Purpose:
- To determine the factors influencing the success of antireflux operations in children.
- To compare the effectiveness of different surgical techniques for correcting VUR.
- To identify predictors of unsatisfactory outcomes in pediatric antireflux surgery.
Summary:
- Surgical method, ureterectasia severity (degree III-IV), and persistent urinary bladder dysfunction significantly influenced antireflux operation results.
- The Politano-Leadbetter and Kohen surgical techniques demonstrated superior outcomes compared to other methods.
- Unsatisfactory results were more common in cases with severe ureterectasia and ongoing bladder dysfunction, increasing over time.
Impact:
- Findings guide the selection of optimal surgical techniques for pediatric VUR based on patient-specific factors.
- Highlights the importance of assessing urinary bladder function alongside VUR severity for predicting surgical success.
- Informs clinical decision-making and patient counseling regarding long-term expectations after antireflux surgery.
Abstract:
Nearest and long-term results of 114 antireflux operations performed on 78 children were studied. Choice of the method of operative intervention, degree of ureterectasia on excretory urograms and functional state of the urinary bladder were shown to have an influence on results of antireflux operations. Best results were obtained following operations after Politano--Leadbetter and Kohen. Unsatisfactory results were mainly observed in III-IV degree ureterectasia and continuing dysfunction of the urinary bladder. Their amount was found to increase with longer terms of observations.