Surgical treatment after the failed antireflux operation

Introduction. Laparoscopic techniques have been applied to ensure surgical treatment of the vesicoureteral reflux (VUR) in children during the last decades. We present the experience of using the laparoscopic extravesical antireflux standard and ureter-fixed modified surgery.Materials and methods. A multi-center prospective experimental clinical historical cohort two-group study of patients with III–V stage primary VUR. The basic group consisted of 48 children who had a unilateral laparoscopic extravesical surgery when the ureter was fixed according to the developed technique. 44 children who had a surgery according to the standard technique were included into the control group.Results. Complete VUR removal was noted in 100% of patients from the basic group and 81.2% of patients from the control group (р <0.01). Preservation of the megaureter with complete reflux resolution was seen in 1 child only (2.1%) from the basic group who had V stage VUR (p=0.2).Conclusions. Laparoscopic extravesical antireflux is a safe and effective surgery. Distal ureter fixation reduces the rate of VUR recurrences.

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Results of laparoscopic extravesical antireflux operation in vesicoureteral reflux in children

Proceedings of the National Academy of Sciences of Belarus Medical series ◽

10.29235/1814-6023-2020-17-4-427-436 ◽

2020 ◽

Vol 17 (4) ◽

pp. 427-436

Author(s):

V. I. Dubrov ◽

A. V. Strotsky

Keyword(s):

Surgical Treatment ◽

Vesicoureteral Reflux ◽

Classical Group ◽

Perioperative Complications ◽

Control Group ◽

Medium Term ◽

Modified Technique ◽

Term Outcome ◽

Antireflux Operation ◽

The Mean

The objective was to improve the results of surgical treatment of vesicoureteral reflux in children, using laparoscopic access. The prospective study was performed in 111 children (137 ureters) with the primary III–IV grade vesicoureteral reflux. The mean age was 34.7 months. The modified laparoscopic antireflux technique was performed on 73 children (91 ureters). We compared the perioperative complications and the medium-term outcome with a group of 38 children (46 ureters) who underwent classical laparoscopic extravesical reimplantation.3 In the modified group, the mean surgery time was 109.8 ± 31.5 minutes for unilateral cases and 176.5 ± 47.6 minutes for bilateral cases; in the classical group, it was 118.6 ± 34.3 and 209.5 ± 51.2 minutes respectively (p > 0.05). Postoperative vesicoureteral reflux had 2 (2.7 %) patients in the main group and 8 (21.1 %) children in the control group (p = 0.002). There was no ureteral obstruction in the both groups. The success rate for ureters was 97.8 % with modified technique versus 82.6 % after classical laparoscopic reimplantation (p = 0.003). Laparoscopic extravesical ureteral reimplantation is a safe and effective surgical procedure. The modified technique may improve the surgical treatment results.

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Human Stapes Crura: Normal Ultrastructure. Scanning Electron Microscopic Findings

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100116267 ◽

1975 ◽

Vol 33 ◽

pp. 528-529

Author(s):

M.D. Graham

Keyword(s):

Electron Microscope ◽

Surgical Treatment ◽

Scanning Electron Microscope ◽

Osmic Acid ◽

Human Cadaver ◽

Electron Microscopic ◽

Scanning Electron Microscopic ◽

Normal Human ◽

Microscopic Findings ◽

Scanning Electron

The recent development of the scanning electron microscope has added great impetus to the study of ultrastructural details of normal human ossicles. A thorough description of the ultrastructure of the human ossicles is required in order to determine changes associated with disease processes following medical or surgical treatment.Human stapes crura were obtained at the time of surgery for clinical otosclerosis and from human cadaver material. The specimens to be examined by the scanning electron microscope were fixed immediately in the operating room in a cold phosphate buffered 2% gluteraldehyde solution, washed with Ringers, post fixed in cold 1% osmic acid and dehydrated in graded alcohol. Specimens were transferred from alcohol to a series of increasing concentrations of ethyl alcohol and amyl acetate. The tissue was then critical point dried, secured to aluminum stubs and coated with gold, approximately 150A thick on a rotating stage in a vacuum evaporator. The specimens were then studied with the Kent-Cambridge S4-10 Scanning Electron Microscope at an accelerating voltage of 20KV.

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