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請使用永久網址來引用或連結此文件:
http://ir.cmu.edu.tw/ir/handle/310903500/21389
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| 題名: | Antireflux surgery of vesicoureteral reflux : experience in China Medical University Hospital |
| 作者: | 陳毓騏(Yu-Chi Chen);張兆祥(Chang,Chao-Hsian);吳錫金(Wu,His-Chin);張士三;陳汶吉(Chen,Wen-Chi) |
| 貢獻者: | 醫學院醫學系學士班泌尿學科;中國附醫泌尿部 |
| 日期: | 2005-03-27 |
| 上傳時間: | 2009-09-07 10:57:32 (UTC+8) |
| 摘要: | PURPOSE: Vesicoureteral reflux (VUR) is a common problem in childhood, affecting more than 10% of all children and up to 70% of infants who present with UTIs. We provide our experience of intravesical surgical intervention of primary VUR after failure of previous medical treatment. MATERIALS AND METHODS: During the period of 1997 to 2004, the cases of primary VUR who underwent intravesical surgical intervention in China Medical University Hospital were studied retrospectively by reviewing medical record. Twenty-three patients were enrolled in this study totally. We analyzed the clinical presentation, operation methods, and surgical outcome. RESULTS: Of the 23 patients, 11 were girls. 7 of 23 were left side, 6 were right side and 10 were bilateral reflux. 34 ureters were underwent intravesical antireflux surgery. Surgical procedures included Politano-Leadbetter (14 ureters) and Glenn-Anderson technique (20 ureters). Preoperative grade of reflux in order of I, II, III, IV, and V was 4 (12.12%), 3 (9.09%), 8 (24.24%), 12 (36.36%) and 6 (18.18%) respectively. Besides, 2 of 34 ureters were incomplete duplication. One patient with Left side Gr IV VUR underwent bilateral antireflux surgery by Glenn-Anderson technique. Median follow-up duration was 5.1 months (range, 0 to 41). VCUG was followed in 12 patients (18 ureters). Reflux was subsided in 15 ureters within 9.33 months averagely (range from 3 to 41 months). Improvement of grade was seen in 1 ureter within 3 months (grade III to grade II). VUR got worse (right:GrII/left:GrIII) in one patient with bilateral VUR before operation (right:GrI/left:GrIII). The rate of improvement was 88.8% CONCLUSIONS: Primary reflux is a congenital anomaly of the UVJ wherein a deficiency of the longitudinal muscle of the intravesical ureter results in an inadequate valvular mechanism. Successful antireflux surgery provides normal renal drainage and eliminates reflux. In our limited series, the success rate was 88.8%. More cases and exper? |
| 關聯: | 台灣外科醫學會第19屆第2次會員代表大會暨第64次學術演講會 |
| 顯示於類別: | [醫學系] 會議論文
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