在爆发之前先想一想:非手术治疗尿道细胞的结果
Zoe S Gan1, Karl F Godlewski2, Suhaib Abdulfattah2
1Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, United States.
Journal of pediatric urology
|October 4, 2024
概括
对儿科尿细胞的观察是有效的,非手术治疗导致二次手术干预的频率较低和延迟. 成功的关键因素包括更小的尿路细胞大小和没有高度囊尿管逆流 (VUR).
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 手术管理的手术管理.
- 尿道瘤学 尿道瘤学
背景情况:
- 尿道经常在产前被诊断出来,并通过微创性内镜穿刺进行管理.
- 非手术管理 (观察) 正在成为选择尿细胞的可行选择,但患者选择标准尚未标准化.
- 这项研究解决了在选择患者进行非手术性尿素结核管理方面达成共识的必要性.
研究的目的:
- 为了比较二次手术干预率和非手术和儿科尿路切片前期切口管理之间的时间.
- 描述成功和失败的非手术治疗儿科尿道细胞的特点.
- 确定影响儿童尿细胞干预的必要性和时间的风险因素.
主要方法:
- 对于287个儿科泌尿器细胞的回顾性审查.
- 非手术管理和前期内镜穿刺之间的结果比较.
- 分析与二次干预和干预时间相关的因素.
主要成果:
- 23%的尿细胞 (65/287) 进行了非手术治疗.
- 非手术治疗导致明显较少 (9%vs. 34%) 和较晚 (平均年龄40岁vs. 20个月) 的二次手术干预.
- 成功的非手术治疗与较少的并发病,较小的尿路细胞大小,没有高等级的膀尿路逆流 (VUR),单一的收集系统,最小的水,和ipsilateral多囊性功能障碍 (MCDK) 相相关.
- 高度VUR,双重系统和女性性别与干预时间更短有关.
结论:
- 非手术治疗对于选择的儿科尿细胞是有效的,可能会延迟或避免二次手术.
- 有利于非手术成功的因素包括较小的尿路细胞大小,没有高等级的VUR,单一系统,ipsilateral MCDK和最小的水.
- 非操作性管理并没有增加早期二次干预的风险.
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