原发性非反流性巨输尿管患者长期随访
作者：Dacia Di Renzo, Liza Aguiar, Valentina Cascini, Marta Di Nicola, et al. 来源：Journal of Urology 日期：2013-03-12
导读
关键字：
巨输尿管
Long-term follow up of primary non-refluxing megaureter
Abstract
Purpose
The purpose of the study was to evaluate outcomes of non-operative management of primary non-refluxing megaureter (PM) at long-term follow-up, and to identify clinical predictors of spontaneous resolution.
Methods
Among 74 patients (88 PMs) diagnosed between 1990-2005, 63 patients (74 PMs) were included in this main study population, observed >6 months followed. Indications for surgery were obstructive hydroureteronephrosis, functional impairment or persistent symptoms.
Results
Twenty of 74 PMs (27%) required surgery up to 7 years after presentation. Surgery was not indicated in 82% PMs with grade <III hydro and 62.9% ≥III (p=ns), 76.5% type I-II PMs and in 33.3% type III (p=0.040), 78.7% renal units with function ≥40 and 0% with function <40% (p=0.027), 80% PMs with a nonobstructive wash-out pattern and 44.4% with intermediate/obstructive pattern (p=0.032), 67.9% of patients with perinatal and 25% with post-neonatal presentation (p=0.008), 63.2% of patients presenting with symptoms and 76.4% of asymptomatic patients (p=ns). On multivariate analysis, age at presentation and wash-out pattern were significant predictors of spontaneous resolution.
Conclusions
Most cases of PM resolve spontaneously or improve without loss of function nor development of symptoms. Careful observation allows surgery to be delayed beyond the neonatal period in most cases. Long-term follow-up is recommended because symptoms can develop years later. Wash-out pattern and age at presentation are statistically significant predictors of spontaneous resolution.
http://www.jurology.com/article/S0022-5347(13)03642-2/abstract
分享：
相关文章
评论
我要跟帖发表
回复 小鸭梨：
发表
