KMID : 0811820090130020229
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Journal of Korean Society of Pediatric Nephrology 2009 Volume.13 No. 2 p.229 ~ p.234
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Efficacy of Dextranomer/Hyaluronic Acid Copolymer (Deflux¨Þ) Injection for Vesicoureteral Reflux in Children
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Hong Suk-Jin
Hwng Hyun-Hee Hong Eun-Hui Cho Min-Hyun Chung Sung-Kwang
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Abstract
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Purpose : The aim of this study was evaluating the efficacy of endoscopic Deflux¨Þ submucosal injection in children with primary vesicoureteral reflux (VUR).
Methods : Retrospective analysis of medical record was conducted on 38 children (59 ureters) who underwent endoscopic Deflux¨Þ injection due to primary VUR. Data were collected from March 2000 to February 2006. Mean infused amount of Deflux¨Þ was 0.77 cc. After Deflux¨Þ injection, patients were reassessed by voiding cystourethrogram (VCUG) 6 months later.
Results : The success rate of endoscopic Deflux¨Þ submucosal injection 6 months later by VCUG was 100% for grade 1 VUR, 87.5% for grade 2, 60% for grade 3, 26.6% for grade 4, 16.6% for grade 5, respectively and there was negatively significant correlation between success rate and grade of VUR (P<0.01). Degree of improvement of VUR by endoscopic Deflux¨Þ submucosal injection was not related to age at diagnosis, time to operation, existence of voiding dysfunction or constipation and infused amount of Deflux¨Þ. However, group with anticholinergics medication had significantly lower success rate than non-medication group (P<0.047).
Conclusion : Endoscopic Deflux¨Þ submucosal injection is effective therapy in patient with primary VUR, especially low grade VUR. It can be not only a useful substitute for prophylaxis with antibiotics, but also an effective management prior to ureteroneocystostomy in children with primary VUR.
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KEYWORD
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Vesicoureteral Reflux, Deflux¨Þ, Child
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