Erschienen in:
01.04.2014 | Original Article
Endoscopic correction of complex cases of vesicoureteral reflux utilizing Vantris as a new non-biodegradable tissue-augmenting substance
verfasst von:
Boris Chertin, Wael Abu Arafeh, Stanislav Kocherov
Erschienen in:
Pediatric Surgery International
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Ausgabe 4/2014
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Abstract
Purpose
We aimed to evaluate prospectively the efficacy of Vantris as a new non-biodegradable tissue-augmenting substance in children with complex cases of VUR.
Materials and methods
Over the last 4 years, 37 children (28 female and 9 male) with a mean age of 5.8 ± 3.1 years (mean ± SD) underwent endoscopic correction of complex VUR. A total of 38 renal refluxing units (RRU) was treated as 5 had persistent reflux after open surgery, 16 had duplication, 4 had Hutch diverticulum, 6 had small poorly functioning kidneys (less than 20 % of relative renal function) with grade V VUR, 2 had ureterocele after puncture, 3 had persistent stump reflux, 1 had prune belly syndrome, and 1 had urogenital sinus. VUR was Grade I in 2, Grade II in 9, Grade III in 11, Grade IV in 10, and Grade V in 6 RRU, respectively.
Results
The reflux was corrected in 34 (89.4 %) RRU after a single injection, after second injection in 2 (5.3 %) RRU. In 2 (5.3 %) RRU, VUR downgraded to Grade I (1RRU) and Grade II (1RRU) and they were taken off antibiotic prophylaxis. VCUG was performed in 11 (73.3 %) of 15 children who completed 1 year and in 3 (33.3 %) of 9 who completed 3 years of follow up as a part of the routine protocol. None showed VUR recurrence. US demonstrated normal appearance of kidneys in all patients.
Conclusion
Our data show that Vantris injection provides a high level of reflux resolution in complex cases of VUR.