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在初级阻塞性大尿道的内镜扩张后的二次手术的风险和保护因素
Sonia Pérez-Bertólez1, Oriol Martín-Solé2, Isabel Casal-Beloy2
1Pediatric Urology Unit, Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2. , 08950, Barcelona, Spain. spbertolez@yahoo.es.
对于一次性阻塞性大尿道的高压气球扩张,当双J支架放置至少55天时,它是有效的. 延长支架持续时间显著减少了对二次手术程序的需求.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 最少侵入性的手术
- 尿道重建 尿道重建
背景情况:
- 主要阻塞性大尿道 (POM) 是一种先天性疾病,影响尿道结.
- 带有双J支架的高压气球扩张 (HPBD) 为POM提供了一种最少的侵入性一线手术选择.
- 尿道再植入或皮肤尿道静止术是另一种手术治疗方法.
研究的目的:
- 为了确定HPBD后POM的二次手术的风险因素.
- 评估HPBD作为POM的主要治疗方法的疗效.
- 为了确定最佳的支架持续时间,以防止治疗失败.
主要方法:
- 从50名接受POMHPBD的儿童 (55名尿道) 收集前性数据 (2007-2021年).
- 多变量后勤回归分析,以确定二次手术的风险因素.
- 对患者人口统计,诊断方式,手术细节和随访数据的分析.
主要成果:
- 19名患者 (37.25%) 需要进行二次泌尿器再植入.
- 渐进性尿道水缩和早期的双J支架切除是重复手术的独立风险因素.
- 每一个额外的支架维护日,都会将重复手术的风险降低7%;最佳切断时间是55天.
结论:
- 保持双J支架至少55天,大大减少了HPBD后对POM进行二次手术的需要.
- 建议至少在HPBD后2个月取出双J导管.
- 延长支架的HPBD是一种可行的POM微创方法.
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