POLIAKRILAT-POLIALKOHOL KOPOLIMER (VANTRIS®) KAO OPCIJA U MINIMALNO INVAZIVNOM ZBRINJAVANJU VEZIKOURETERALNOG REFLUKSA: NAŠE ISKUSTVO
Sažetak
Minimalno invazivno zbrinjavanje vezikoureteralnog refluksa u poslednjim decenijama postalo je popularno, i to zbog brojnih prednosti same procedure, koju odlikuju jednostavno izvođenje, kraće vreme izvođenja nego kod otvorenih tehnika, retka pojava ozbiljnijih komplikacija, kao i skraćivanje boravka u bolnici. Postoje dve grupe injekcionih agenasa za augmentaciju tkiva: biorazgradivi i nebiorazgradivi. Vantris® (poliakrilat-polialkohol kopolimer) predstavlja kombinaciju ovih dveju grupa.
Cilj studije bilo je utvđivanje efikasnosti kopolimera Vantris® kao opcije u minimalno invazivnom zbrinjavanju vezikoureteralnog refluksa (VUR).
Sproveli smo prospektivnu studiju koja je obuhvatila period od pet godina (2015‒2019). Ukupno je 24 bolesnika, tj. 39 renalnih refluksivnih jedinica bilo tretirano koplimerom Vantris®
Refluks je bio jednostran kod devet bolesnika (37,5%), a obostran kod 15 bolesnika (62,5%). Stepen refluksa bio je V kod dva uretera (5,12%), IV kod šest uretera (15,38%), III kod 22 uretera (56,42%), II kod tri uretera (7,69%) i I kod šest uretera (15,38%). Srednje vreme praćenja iznosilo je 12 meseci i uključivalo je pregled urina, ultrazvučni pregled urinarnog trakta i mikcionu cistouretrografiju nakon godinu dana. Refluks je eliminisan u 36 uretera (92,31%). Kod dvoje bolesnika razvila se opstrukcija vezikoureteralnog spoja. Kod jednog bolesnika bio je potreban dodatni injekcioni tretman.
Vantris® se za tretiranje VUR-a može koristiti uspešno i sa malim procentom komplikacija. Budući da je primena jednostavna, a stopa komplikacija svedena na minimum, mogao bi postati tretman izbora za lečenje VUR-a.
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