How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?

Çıtamak, Burak; Dogan, Serkan; CEYLAN, TANER; HAZIR, Berk; TEKGUL, SERDAR; Artykov, Meylis; Haberal, Hakan Bahadır

doi:10.4274/atfm.galenos.2020.74436

How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?

Burak ÇITAMAK, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Hasan Serkan DOĞAN, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Taner CEYLAN, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Hakan Bahadır HABERAL, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Meylis ARTYKOV, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Berk HAZIR, (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Serdar TEKGÜL (Hacettepe Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Yıl: 2020 Cilt: 73 Sayı: 1 Sayfa Aralığı: 60 - 64 Metin Dili: İngilizce DOI: 10.4274/atfm.galenos.2020.74436 İndeks Tarihi: 24-10-2020

How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?

Öz:

Objectives: To compare the resolution of reflux after surgery and follow-up and to determine what the appropriate treatment is in patients withvesicoureteral reflux (VUR) who were diagnosed less than 2 years of age.Materials and Methods: Data from 250 patients who were diagnosed with VUR below 2 years of age between 2000 and 2016 were examinedretrospectively. Patients with low risk and moderate risks according to the EAU/ESPU guidelines were evaluated. Patients who underwent surgeryand followed up were compared regarding the age at diagnosis, VCUG findings, gender, presence of scar in DMSA, BTI, postoperative UTI, follow-upperiod and resolution rates.Results: Of the patients, 207 patients underwent surgery while 43 did not. Mean age was 9.62 (0-24) months. Follow-up patients were followed upfor an average of 55.4 months. Of the followed-up patients, 60.5% (26) had complete resolution of VUR at the average of 25.8 months (6-64). Whenwe compared the data of surgically treated and followed-up patients, we detected that frequency of male gender, renal scar, high-grade reflux andmoderate risk were significantly more, the resolution rate was higher and follow-up period was shorter in operated group.Conclusion: Spontaneous resolution rate of VUR less than 2 years of age is high and it is important to determine which patients should undergoearly surgery in this patient group in terms of preventing complications. Surgical options with satisfactory success rates should be discussed withthe family. Besides, the possible costs and comorbidities should also be regarded.

Anahtar Kelime:

Düşük ve Orta Riskli Vezikoüreteral Reflüsü Olan Çocukların Takip veya Opere Edildiğindeki Sonuçları Nasıldır?

Öz:

Amaç: İki yaş altı tanı konan vezikoüreteral reflü (VUR) hastalarında cerrahi ve takip hastalarının başarılarını karşılaştırarak, bu hasta grubunda uygun tedavinin ne olduğunu ortaya koymaktır. Gereç ve Yöntem: 2000-2016 tarihleri arasında 2 yaş altında VUR tanısı olan, EAU/ESPU kılavuzlarına göre düşük ve orta riskli olan ve tüm datasına ulaşılan 250 hastanın verileri retrospektif olarak incelendi. Hastaların tanı anındaki yaşları, VCUG verileri, cinsiyeti, DMSA bulgularında skar olup olmadığı, araya giren enfeksiyon, postoperatif idrar yolu enfeksiyonu, takip süreleri ve başarıları karşılaştırıldı. Bulgular: Hastaların 43’ü cerrahi işlem olmadan takip edilmiş, 207’si ise cerrahi işlem geçirmiştir. Hastaların ortalama yaşı 9,62 (0-24) ay bulundu. Takip hastaları ortalama 55,4 ay takip edildi. Takipteki hastaların %60,5’inde (26) VUR ortalama 25,8 ayda (6-64) tam rezolüsyona uğradı. Cerrahi olarak tedavi edilen ve takip edilen hastaların verilerini karşılaştırıldığında, opere edilen grupta, erkek cinsiyet, böbrek skarı, yüksek dereceli reflü ve orta risk varlığının anlamlı derecede daha fazla olduğu, reflünün çözünme oranının yüksek olduğu ve takip süresinin daha kısa olduğu tespit edildi. Sonuç: İki yaş altında VUR tanısı alan hastaların spontan rezolüsyon oranı yüksek olup, bu hasta grubunda hangi hastanın erken dönemde cerrahi girişim yapılması gerektiği komplikasyonları önleme açısından önemlidir. Cerrahi seçenek ise tatmin edici başarı oranları ile mutlaka aile ile tartışılmalı ancak olası maliyet ve komorbiditeleri de unutulmamalıdır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Çıtamak B, Dogan S, CEYLAN T, Haberal H, Artykov M, HAZIR B, TEKGUL S (2020). How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. , 60 - 64. 10.4274/atfm.galenos.2020.74436
Chicago	Çıtamak Burak,Dogan Serkan,CEYLAN TANER,Haberal Hakan Bahadır,Artykov Meylis,HAZIR Berk,TEKGUL SERDAR How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. (2020): 60 - 64. 10.4274/atfm.galenos.2020.74436
MLA	Çıtamak Burak,Dogan Serkan,CEYLAN TANER,Haberal Hakan Bahadır,Artykov Meylis,HAZIR Berk,TEKGUL SERDAR How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. , 2020, ss.60 - 64. 10.4274/atfm.galenos.2020.74436
AMA	Çıtamak B,Dogan S,CEYLAN T,Haberal H,Artykov M,HAZIR B,TEKGUL S How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. . 2020; 60 - 64. 10.4274/atfm.galenos.2020.74436
Vancouver	Çıtamak B,Dogan S,CEYLAN T,Haberal H,Artykov M,HAZIR B,TEKGUL S How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. . 2020; 60 - 64. 10.4274/atfm.galenos.2020.74436
IEEE	Çıtamak B,Dogan S,CEYLAN T,Haberal H,Artykov M,HAZIR B,TEKGUL S "How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?." , ss.60 - 64, 2020. 10.4274/atfm.galenos.2020.74436
ISNAD	Çıtamak, Burak vd. "How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?". (2020), 60-64. https://doi.org/10.4274/atfm.galenos.2020.74436

APA	Çıtamak B, Dogan S, CEYLAN T, Haberal H, Artykov M, HAZIR B, TEKGUL S (2020). How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 73(1), 60 - 64. 10.4274/atfm.galenos.2020.74436
Chicago	Çıtamak Burak,Dogan Serkan,CEYLAN TANER,Haberal Hakan Bahadır,Artykov Meylis,HAZIR Berk,TEKGUL SERDAR How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. Ankara Üniversitesi Tıp Fakültesi Mecmuası 73, no.1 (2020): 60 - 64. 10.4274/atfm.galenos.2020.74436
MLA	Çıtamak Burak,Dogan Serkan,CEYLAN TANER,Haberal Hakan Bahadır,Artykov Meylis,HAZIR Berk,TEKGUL SERDAR How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol.73, no.1, 2020, ss.60 - 64. 10.4274/atfm.galenos.2020.74436
AMA	Çıtamak B,Dogan S,CEYLAN T,Haberal H,Artykov M,HAZIR B,TEKGUL S How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020; 73(1): 60 - 64. 10.4274/atfm.galenos.2020.74436
Vancouver	Çıtamak B,Dogan S,CEYLAN T,Haberal H,Artykov M,HAZIR B,TEKGUL S How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2020; 73(1): 60 - 64. 10.4274/atfm.galenos.2020.74436
IEEE	Çıtamak B,Dogan S,CEYLAN T,Haberal H,Artykov M,HAZIR B,TEKGUL S "How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?." Ankara Üniversitesi Tıp Fakültesi Mecmuası, 73, ss.60 - 64, 2020. 10.4274/atfm.galenos.2020.74436
ISNAD	Çıtamak, Burak vd. "How the Outcome of Infants with Low and Moderate Risks of Vesicoureteral Reflux Differs when They are Managed Conservatively or Operated?". Ankara Üniversitesi Tıp Fakültesi Mecmuası 73/1 (2020), 60-64. https://doi.org/10.4274/atfm.galenos.2020.74436