88 / 492
S4-12
(P)
SUCCESS RATES OF ENDOSCOPIC OR OPEN SURGERY ACCORDING TO RISK
GROUPS IN CHILDREN WITH VUR - IS RISK GROUPING NECESSARY WHEN
SURGERY IS PLANNED?
Bilge KARABULUT
1
, Koray AGRAS
1
, Atilla SENAYLI
2
and Tugrul TIRYAKI
2
1) Ataturk Teaching and Research Hospital, Department of Urology, Division of Pediatric Urology, Ankara, TURKEY - 2)
Ankara Pediatrics, Hematology and Oncology Teaching and Research Hospital, Department of Pediatric Surgery, Division
of Pediatric Urology, Ankara, TURKEY
PURPOSE
Success rates of surgical treatment in children with VUR were evaluated in different risk groups described in Pediatric
Urology Guidelines 2015.
MATERIAL AND METHODS
Data from patients treated by either endoscopic (STING) or open surgery between 2009-2014 were retrospectively
analyzed (n=250). Toilet trained, older (>4 years) patients having high-grade VUR (grade 4 and 5) and renal scarring
were considered as “high-risk group’’; patients without kidney damage and with low-grade VUR (grade 1,2 and 3)
were considered as “low-risk group’’; all other cases who didn’t meet these two were considered as “moderate-risk
group’’. Treatment was considered "successful" in cases with no VUR and no UTI in the follow-up.
RESULTS
The mean age was 6.5±3.5 years. Forty one patients were exluded because of inadequate data. Of the remaining 209
patients, 63 were in low, 97 were in moderate and 49 were in the high-risk groups.
Table: Sucessful cases (n) / Total cases (n) (%)
UNILATERAL VUR
BILATERAL VUR
First STING
success
Overall STING
success
Open Surgery
success
First STING
success
Overall STING
success
Open Surgery
success
LOW RISK
27/42 (64%)
39/42 (92%)
2/3 (67%)
15/21 (71%)
18/21 (88%) 3/3 (100%)
MODERATE
RISK
32/49 (65%)
42/49 (86%)
10/10 (100%) 10/42 (24%)
33/42 (79%)
10/12 (83%)
HIGH RISK
5/19 (26%)
11/19 (58%)
10/11 (91%)
2/20 (10%)
16/20 (80%)
10/11 (91%)
TOTAL 64/110 (58%) 92/110 (84%)
22/24 (92%)
27/83 (33%)
67/83 (81%)
23/26 (88%)
p Value
0.008*
0.003*
0.18
0.001*
0.78
0.68
CONCLUSIONS
STING and open surgery provides success rates of 58-92% and 67-100% respectively, depending on the risk
group. Because low and moderate risk patients have similar surgical results in unilateral cases, risk grouping as high
and non-high risk seems satisfactory for unilateral VUR. Surgical results do not change between risk groups of bilateral
cases.