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PubMed2006

[Results of reimplantation for infected total knee arthroplasty: 107 cases].

PURPOSE OF THE STUDY: The purpose of this study was to assess the results of reimplantations of total knee arthroplasties complicated by infection. Outcome was assessed in terms of eradicated infection and function. MATERIAL AND METHODS: This retrospective multicentric study included 107 cases of infected total knee arthroplasties treated by changing the implants. Seventy-seven patients had a two-stage revision and thirty had a one-stage procedure. Patients were reviewed with a minimal 2-year and an average 52-month follow-up. RESULTS: Revision arthroplasty (one- or two-stage) eradicated infection in two out of three patients. With a two-year follow-up, revision arthroplasty was successful in 77% of patients without any sepsis risk factor, in 65% of patients with one risk factor and in 33% of patients with at least two risk factors. After reimplantation for total knee arthroplasty infection, overall function outcome was good (KS knee score: 74.8 after two-stage revision and 75.5 after one-stage revision, NS). After two-stage procedures, the knee outcome was excellent in one-third of patients, good in another third and fair or poor in the final third. After one-stage reimplantation, 40% of the knees had an excellent outcome, 30% a good outcome and 30% a fair or poor outcome. Regarding functional outcome, overall results were fair (KS function score 62.5 for one-stage and two-stage revisions). Functional outcome was fair or poor in 42% of patients with a two-stage procedure and in 55% of patients with a one-stage revision (NS). DISCUSSION: Our study was unable to disclose any difference between one-stage and two-stage revision for eradicating infection. Unfavorable systemic and local conditions decreased the rate of success after revision total knee arthroplasty for infection. Length of infection before reimplantation, number of surgical procedures and bacterial virulence or resistance were not, in our series, predicting factors for failure of septic revision total knee arthroplasty. No difference was found for the clinical and functional results between one-stage and two-stage procedures. Functional outcome was fair or poor for half of the patients after septic revision total knee arthroplsty. The use of an external device between the two procedures for two-stage revision significantly decreased the functional outcome compared with the use of a spacer. Articulated spacers did not offered any advantage compared with a static spacer for functional outcome.

Adolescent↗
PubMed2001

Cystoscopy at the time of ureteral reimplantation for primary vesicoureteral reflux: is it necessary? Incidence of undetected anomalies and cost.

OBJECTIVES: To evaluate the impact on the planned procedure and associated cost of cystoscopy performed immediately before the surgical repair of vesicoureteral reflux. Cystoscopy is commonly performed at the time of ureteroneocystostomy to rule out a previously unsuspected anomaly such as ureterocele or ureteral duplication. METHODS: We retrospectively reviewed the results of preoperative voiding cystourethrograms and ultrasound studies performed on 128 patients who underwent ureteral reimplantation for primary vesicoureteral reflux between 1994 and 2000. Radiographic findings were compared with observations made at cystoscopy and reimplantation to determine the rate of unsuspected ureterocele or duplication in the presence of a radiologic evaluation considered adequate by the operating surgeon and/or radiologist. We then performed an itemized analysis to determine the cost cystoscopy contributed to the procedure. RESULTS: Of the 128 patients, 1 (0.7%) was found to have a small, undiagnosed ureterocele at cystoscopy. A review of this patient's preoperative evaluation revealed that her ultrasound examination was incomplete, lacking views of the bladder. At our institution, cystoscopy increased the total direct and indirect operating room costs of this procedure by 16.2%, adding $123.77 to the original cost of $762.97. CONCLUSIONS: Routine cystoscopic examination before ureteral reimplantation in the setting of an adequate preoperative radiologic evaluation yields little diagnostic information. In this series, it did not have an impact on the surgical procedure to be performed but did add significantly to the cost. Cystoscopy before ureteral reimplantation for primary reflux should only be considered in those children with suspicious or inadequate radiologic studies.

Cystoscopy↗
PubMed2001

Orthotopic reimplantation of cryopreserved ovarian cortical strips after high-dose chemotherapy for Hodgkin's lymphoma.

BACKGROUND: Infertility is a common late effect of chemotherapy and radiotherapy, and has a substantial effect on the quality of life for young survivors of cancer. For men, semen cryopreservation is a simple way of preserving reproductive potential but for women, storage of mature eggs rarely proves successful, and the alternative-immediate in vitro fertilisation with cryopreservation of embryos-is not always appropriate. Reimplantation of cryopreserved ovarian tissue has been shown to restore natural fertility in animals. We applied this technique in a woman who had received sterilising chemotherapy for lymphoma. METHODS: A 36-year-old woman underwent a right oophorectomy with cryopreservation of ovarian cortical strips before receiving high-dose CBV chemotherapy for a third recurrence of Hodgkin's lymphoma. 19 months later, when serum sex steroid analysis confimed a postmenopausal state, two ovarian cortical strips were thawed and reimplanted-one onto the left ovary and another at the site of the right ovary. FINDINGS: 7 months after reimplantation of ovarian cortical strips, the patient reported resolution of hot flashes and, for the first time, oestradiol was detected in the serum. This finding was associated with a decrease in the concentrations of follicle-stimulating hormone and luteinising hormone, and ultrasonography revealed a 10 mm thick endometrium, a poorly visualised left ovary, and a 2 cm diameter follicular structure to the right of the midline. The patient had one menstrual period, but by 9 months after the implantation, her sex steroid concentrations had returned to those seen with ovarian failure. INTERPRETATION: Orthotopic reimplantation of frozen/thawed ovarian cortical strips is a well tolerated technique for restoring ovarian function in women treated with sterilising chemotherapy for cancer.

Adult↗
PubMed1998

Shortening and reimplantation for tortuous internal carotid arteries.

PURPOSE: The purpose of this study was to assess the outcome after the shortening and reimplantation of tortuous internal carotid arteries to prevent kinking after endarterectomy. METHODS: Through a review of prospective records, we studied patients who underwent carotid endarterectomy (CEA) (n = 233) between 1993 and 1996 who had symptomatic stenosis of the internal carotid artery (ICA) of more than 70%. An elongated proximal ICA was excised, and the ICA was reimplanted into the bifurcation in 30 (13%) patients, with additional patch angioplasty in 5 patients. Of the remaining 203 patients, 50 (21%) had Dacron patch angioplasty, and the rest had conventional CEA with simple closure. RESULTS: In the reimplanted group, one patient had a minor stroke with complete recovery on discharge. Three patients (10%) had neck hematomas requiring reexploration, but in none of these was the bleeding from the artery. At mean follow-up of 15 months, 93% of the arteries were widely patent. Significant stenosis secondary to neointimal hyperplasia was detected in only two patients, for a restenosis rate of 6.7%, which is in line with other published reports. In the control group, 8 (3.9%) patients had perioperative transient ischemic attacks, 5 (2.5%) had strokes, and 13 (6.4%) had hematomas requiring evacuation. At follow-up, 14 (6.9%) of the arteries had restenosed. CONCLUSION: In carotid surgery, reconstructive techniques must be tailored to operative findings. Excision of a tortuous elongated proximal ICA with reimplantation is not associated with additional mortality or morbidity rates over those of conventional CEA alone and has the advantage of removing disease at the bifurcation. This procedure was carried out in 13% of our patients and should be a procedure with which the vascular surgeon is familiar.

Aged↗
PubMed1988

Two-stage reimplantation of septic total knee arthroplasty. Report of three cases using an antibiotic-PMMA spacer block.

The management of an infected total knee implant is a major challenge to the orthopaedic surgeon. This article reviews the use of antibiotic-PMMA spacer block in two-stage reimplanation of septic total knee arthroplasties. In addition to serving as an antibiotic delivery system between the time of component removal and reimplantation, the antibiotic-impregnated spacer block imparts mechanical stability to the joint and decreases the morbidity during the period before reimplantation. This temporary "interposition arthroplasty" facilitates the patient's ambulation and also simplifies dissection at the time of reimplantation. Furthermore, osteoporotic bone at the time of resection becomes firm, good-quality bone by the time of reimplantation.

Aged↗
PubMed1989

Reimplantation of infected total hip arthroplasties in the absence of antibiotic cement.

Twenty-two patients with deep infection of the hip were reimplanted and followed for a minimum of 3 years. All reimplantations were done without antibiotic-impregnated cement. Nine were done using cemented and 13 using cementless components. Two patients had recurrent infection. Both of these had primary Pseudomonas infections and had cemented revisions. At 3 or more years, 91% of patients are infection-free as determined by clinical evaluation, erythrocyte sedimentation rate, and, in a few, aspiration. Cemented hips had less pain than cementless hips, although both had equivalent functional scores. The significance of these findings is that reimplantation of infected hips can be successfully accomplished without antibiotic-impregnated cement. Cementless fixation can therefore be used. Clinical results with cementless hips for reimplantation will improve with current designs and techniques.

Aged↗
PubMed1998

Results of 2-stage reimplantation for infected total knee arthroplasty.

Optimum treatment of the infected total knee arthroplasty has not been clearly established. To clarify the efficacy of two-stage reimplantation, experience with 66 infected total knee arthroplasties in 64 patients who had been treated with 2-stage reimplantation total knee arthroplasty between September 1980 and October 1993 was reviewed. Of these, 55 knees in 54 patients were available for follow-up examinations at an average of 61.9 months (range, 28-146 months). The initial diagnoses were rheumatoid arthritis (14 knees) and osteoarthritis (41 knees). Reimplantation was successful in 80.0% of knees with low-virulence organisms (coagulase-negative Staphylococcus, Streptococcus), 71.4% with polymicrobial organisms, and 66.7% with high-virulence organisms (methicillin-resistant Staphylococcus aureus). Reimplantation was successful in 82% of patients with osteoarthritis and in 54% of patients with rheumatoid arthritis (P = .024). The success rate was 92% if infection occurred after primary arthroplasty but only 41% if after multiple previous knee operations (arthroscopy, osteotomy, or revision total knee arthroplasty) (P < .001).

Adult↗
PubMed1994

Magnetic resonance assessment of microvascular patency in reimplanted rabbit ears.

RATIONALE AND OBJECTIVES: Magnetic resonance angiography (MRA) provides a means of noninvasive vascular imaging of microvascular vessels. Before conducting comparative studies and value assessments of a new method, it is necessary to evaluate the reproducibility and reliability of the technique. In an experimental study with five rabbits, we investigated the feasibility of MRA imaging of microsurgical vessels. We also attempted to demonstrate the reproducibility of the method. METHODS: We performed MRA imaging of the vascular tree of five New Zealand white rabbit ears, including normal ears, after microvascular reimplantation of the ear and in occlusion experiments on the ear. Scans of four reimplanted ears were performed after the microvascular procedure. In four occlusion experiments, the central vessels were totally occluded by a ligature, and scans were carried out prior to and immediately after occlusion. We used a fast imaging with steady-state precession (FISP) three-dimensional (3-D) rephased-dephased sequence (28-msec repetition time [TR], 18-msec echo time [TE], and a 20 degrees flip angle). RESULTS: In normal rabbit ears and in the reimplantation cases, MRA imaging was able to show the flow within the vascular tree. In the reimplanted ears, MRA images confirmed patency in all anastomosed vessels. The diagnosis of occlusion appeared to be secure in the fully completed experiments (two of four) when it was based on the absence of a signal in the occluded vessels. Because of poor image quality during preligation scanning, we prematurely canceled two experiments. CONCLUSIONS: This study demonstrates that MRA imaging could correctly identify 1-mm vascular channels. Because of the long acquisition time, motion could compromise the reliability of the technique in human subjects.

Animals↗
PubMed2002

Catheter-less Cohen transtrigonal ureteric reimplantation.

OBJECTIVE: To review the profile and outcome of patients in whom it was elected not to insert a bladder catheter as part of the management of Cohen transtrigonal ureteric reimplantation surgery. PATIENTS AND METHODS: Between April 2000 and April 2001, 37 patients underwent ureteric reimplantation by the senior author, using the Cohen transtrigonal technique. The use of the catheter-less protocol began after the blockage of a suprapubic catheter soon after surgery; the catheter was removed with no adverse event. Subsequently, 27 of those undergoing ureteric reimplantation were selected not to have a bladder catheter. Later in the study a greater proportion of patients had no catheter inserted, as confidence with the catheter-less technique increased. Caudal anaesthetic, oral analgesia and a single dose of intravesical bupivacaine were used for pain relief. The children were monitored closely after surgery and a urethral catheter inserted in the one patient who had not voided after 6 h. RESULTS: The patients generally tolerated the lack of a bladder catheter well. Of the 27 patients who did not have a catheter inserted at surgery, one required catheterization (a girl with bilateral duplex systems and large ureteroceles). Two children stayed in hospital for 2 days after surgery, one was discharged on the day of surgery, and the remainder went home on oral analgesia on the first day after surgery. Since starting the catheter-less approach, 10 patients have had a suprapubic catheter because they had more complex surgery, were older or because the approach had not developed sufficiently at the time of surgery. CONCLUSIONS: Intravesical ureteric reimplantation is not only safe when omitting a bladder catheter but, if used selectively, there appears to be a significant decrease in the hospital stay and discomfort after surgery.

Adolescent↗
PubMedDate not supplied

Tensile strength of the supraspinatus after reimplantation into a bony trough: an experimental study in rabbits.

The goals of this study were to determine the strength of the supraspinatus tendon after reimplantation into a bony trough and to find out whether the fibrocartilaginous enthesis reformed. In 21 rabbits, the supraspinatus tendon was transected and reinserted into a bony trough at the greater tuberosity. After sacrifice at 8 and 12 weeks, tensile strength was measured. Microscopically, the presence of fibrocartilage and the spatial orientation of the cartilage columns and collagen fibers were assessed. At sacrifice, 14 of 21 reinserted specimens had healed successfully and were studied. Most mechanical failures occurred through bone, and none failed at the site of reimplantation. The mean peak loads of the operated tendons were significantly lower than their controls (8 weeks, 134.8 +/- 49.9 N vs 223.1 +/- 33.4 N, and 12 weeks, 172.2 +/- 68.2 N vs 274.1 +/- 70.0; P =.013 and P =.025, respectively). Histologically, at 8 weeks, the fibrocartilaginous enthesis had partially reformed; it was narrower than normal, and the collagen fibers had only partially assumed their normal spatial arrangement. Twelve weeks after reimplantation, 4 of 7 entheses had a normal histologic appearance. We conclude that return of strength of the supraspinatus tendon is evident 8 weeks after surgical reattachment into a bony trough and that the fibrocartilaginous enthesis is normal in over half of the specimens at 12 weeks. The subchondral bone was weaker than the reinserted tendon. The results support the clinical practice of surgical reimplantation. Avoiding active exercises early while promoting them later could improve the surgical results and reduce the effects of disuse.

Animals↗
PubMed2003

Sensory recovery after hand reimplantation: a clinical, morphological, and neurophysiological study in humans.

Despite fairly good return of motor function, patients who have amputated hands reimplanted demonstrate poor sensory recovery and severe cold intolerance, two variables that are difficult to quantify reliably. In this study we wanted to find out if there is a correlation between morphological findings of sensory and sympathetic reinnervation and clinical and neurophysiological variables. Skin was biopsied from the reimplanted and corresponding area in the normal hands of eight patients who had sustained a hand amputation and subsequent reimplantation. The sections were immunostained using markers for both sensory and sympathetic nerve fibres. Comparison between the reimplanted and normal sides in each individual showed a mean loss of sensory immunoreactive nerve fibres of 30%, and for sympathetic immunoreactivity the loss was 60%. There was measurable two-point discrimination in the injured hand only in patients below the age of 40 years, corresponding to the better recovery of mechanical thresholds evaluated neurophysiologically for this age group. These results confirm the extensive loss of sensory nerve fibres after nerve injury, probably correlated to loss of sensory neurons. We have also shown that it is possible to correlate the results of clinical and neurophysiological evaluation with morphological results of skin reinnervation specific to the repaired nerve, and so improve the possibility for the quantification of sensory recovery.

Adolescent↗
PubMed2000

Laparoscopic extravesicular ureteral reimplantation for vesicoureteral reflux: recent technical advances.

Ureteral reimplantation is an effective treatment for primary vesicoureteral reflux. Recent efforts have been directed toward reducing the perioperative morbidity of open reimplantation. We have refined the technique of laparoscopic extravesical ureteral reimplantation with emphasis on minimal tissue dissection, achieving reliable detrusor closure, and downsizing ports and instruments. With our current technique, excellent results comparable to those of established open procedures are achieved, while postoperative discomfort and the recovery period are significantly reduced. The laparoscopic technique of ureteral reimplantation is described, with emphasis on key technical modifications crucial to the ease of performance and a successful outcome.

Cystoscopy↗
PubMed2000

Survival and regeneration of motoneurons in adult rats by reimplantation of ventral root following spinal root avulsion.

The present study examines whether reimplantation of the ventral root could prevent motoneuron death after root avulsion. In the control animals about 65% or 39% of motoneurons survived at 3 or 6 weeks post-injury respectively. More than 60% of them expressed nitric oxide synthase (NOS). In contrast, in animals with ventral root reimplantation, nearly 90% or 80% of motoneurons survived at 3 or 6 weeks post-injury respectively. Expression of NOS due to root avulsion was significantly inhibited in these experimental animals. More interestingly, about 80% of the surviving motoneurons were found to regenerate their axons into the reimplanted ventral root, and all of these regenerating motoneurons were NOS negative. Results of the present study show that reimplantation of avulsed ventral root can greatly enhance motoneuron survival and the surviving motoneurons can regrow their axons into the original ventral root.

Animals↗
PubMed1998

Modified Lich-Gregoir ureteral reimplantation: experience of a Canadian center.

PURPOSE: Various techniques of ureteral reimplantation have been described for correction of vesicoureteral reflux. We report our experience regarding the safety and efficacy of a modified Lich-Gregoir extravesical approach. MATERIAL AND METHODS: From January 1991 to January 1996 we evaluated prospectively 256 patients who underwent a modified Lich-Gregoir procedure for correction of vesicoureteral reflux. A total of 385 vesicoureteral units were reimplanted, including 41 duplex systems. The modification to the Lich-Gregoir technique we used consists of ending the paraureteral myotomy with an inverted Y, which permits easier detrusor muscle reapproximation. RESULTS: This procedure was successful initially in 214 of 237 patients, as confirmed by a normal voiding cystourethrogram 4 to 6 months postoperatively. Of the 237 cases persistent vesicoureteral reflux developed in 13 patients, which resolved spontaneously in 9 after 1 year, contralateral reflux developed in 8, which was treated conservatively, and ureteral obstruction developed in 2. Thus, the 1-year overall success rate was 96%. Urinary retention developed in 12 children with bilateral reimplantation (8.3%) with successful recovery in all after conservative management with urethral catheter drainage of 1 week or less. The duration of hospitalization after surgery ranged from 1 to 3 days. CONCLUSIONS: The modified Lich-Gregoir technique of extravesical ureteral reimplantation is successful, simple to perform, reproducible and associated with low morbidity. It also requires minimal hospital stay. These results should encourage the use of this technique when indicated to correct vesicoureteral reflux in children.

Adolescent↗
PubMed2004

Two-stage reimplantation of total joint infections: a comparison of resistant and non-resistant organisms.

The prevalence of resistant organisms has increased throughout the last decade. In order to determine best treatment strategies, studies on reimplantation must address this population. The purpose of this study is to compare the results of delayed reconstruction for total joint infections caused by methicillin-sensitive and methicillin-resistant organisms. This investigation included 46 patients (21 men, 25 women) with an average age 67 years (range, 36-86 years) who had a two-staged reimplantation after periprosthetic total joint infection. Thirty-seven patients cultured methicillin-sensitive organisms and nine cultured methicillin-resistant organisms. Treatment included resection, aggressive debridement, 6 weeks of parenteral antibiotics, and subsequent debridement and reimplantation. Treatment was considered successful if the patient was disease free at last followup (average 5 years, range 2-10 years). The efficacy of two-stage reconstruction was similar for infections with sensitive and resistant bacteria. Only 3 of 46 patients failed delayed reconstruction requiring further treatment. Failure rates with regards to infections with sensitive bacteria were 5.4% (2 of 37 infections) and resistant bacteria 11.1% (1 of 9 infections), which was not significant. The current study shows clinical success of two-stage reimplantation for patients with methicillin-resistant bacteria complicating total joint arthroplasty.

Adult↗
PubMed2006

Dislocation of the hip after reimplantation for infection: an analysis of risk factors.

Dislocation is a well documented complication after a two-stage revision arthroplasty for a deep periprosthetic hip infection. We are aware of no reports specifically evaluating the risk factors for dislocation after reimplantation for infection. We hypothesized greater age, increase in the number of operations on the hip, increase in the length of time from resection to reimplantation, greater limb length discrepancy, smaller femoral offset, and using smaller femoral heads would increase the risk of dislocation. We retrospectively reviewed 34 patients who had a two-stage hip revision for periprosthetic infection with a minimum followup of 2 years. Risk factors for dislocation were evaluated. We compared the rate of dislocation in this group to those patients having revision for aseptic failure. Sixteen dislocations occurred in five (14.7%) of 34 patients. Dislocation occurred in three (1.7%) of 171 patients having revision for aseptic failure. In this small series, age at reimplantation, number of previous operations on the hip, length of time from resection to reimplantation, limb length discrepancy, femoral offset, and femoral head size did not seem to be risk factors for dislocation.

Age Distribution↗
PubMed2004

Serum potassium and creatinine changes following unstented bilateral ureteral reimplantation in children.

PURPOSE: We assess the incidence of electrolyte and creatinine changes following unstented bilateral ureteral reimplantation and attempt to identify associated risk factors. MATERIALS AND METHODS: A total of 107 consecutive children with bilateral vesicoureteral reflux underwent bilateral unstented ureteral reimplantation. Study exclusion criteria were plication or tapering of any ureter, age less than 1 year and/or baseline serum creatinine greater than twice normal for age. Postoperatively serum electrolytes and creatinine were assessed by venous puncture until values normalized. The presence of nausea, vomiting, urinary retention and oliguria were recorded. RESULTS: Of the patients 46 females and 10 males 1.0 to 10.9 years old met the study criteria and had complete data available. Four patients (7.1%) had postoperative potassium greater than or equal to 5.0 mmol/l (range 5.0 to 5.3), including 3 (75%, p = 0.0238) who received potassium supplemented intravenous fluid postoperatively. Eight (14.3%) patients had postoperative creatinine greater than 1 mg/dl (range 1.3 to 2.3) and concurrent hyperkalemia with increased creatinine occurred in 2 (25%, p = 0.0295). Nausea and vomiting beyond postoperative day 1 were noted in 6 patients (75%, p = 0.0122). Neither oliguria nor urinary retention reached statistical significance in correlation with increased potassium and/or creatinine. However, urine retention approached statistical significance in patients with increased creatinine (p = 0.0747). No adverse effects from hyperkalemia were noted. CONCLUSIONS: Adverse effects from hyperkalemia following unstented bilateral ureteral reimplantation are uncommon. Potassium containing intravenous fluids should be avoided in the early postoperative period. Routine serum electrolyte determination may be helpful in patients undergoing unstented bilateral ureteral reimplantation when persistent nausea, emesis or urinary retention is present.

Child↗
PubMed2005

Kidneys with reflux nephropathy maintain relative renal function after ureteral reimplantation.

PURPOSE: In children with severe unilateral reflux nephropathy and diminished relative renal function (RRF) a dilemma exists between the choice of treatment with ureteral reimplantation or nephrectomy. Limited followup data are available regarding relative renal function or postoperative complications after ureteral reimplantation in kidneys with significant unilateral reflux nephropathy. MATERIALS AND METHODS: We retrospectively reviewed the records of 460 patients who underwent ureteral reimplantation between 1980 and 2002, and identified children with primary vesicoureteral reflux and severe unilateral reflux nephropathy (RRF 30% or less on renal scintigraphy). The postoperative outcomes were assessed for relative renal function and complications including hypertension, pyelonephritis or persistent reflux. RESULTS: A total of 18 girls and 14 boys with a mean preoperative relative renal function of 20.1 +/- 7.8% (range 2% to 30%) met the inclusion criteria. Reflux grade in the poorly functioning kidney was II in 4 children (13%), III in 14 (44%), IV in 11 (34%) and V in 3 (9%). Reflux was unilateral in 15 children (47%) and bilateral in 17 (53%). Mean followup from surgery was 3.7 years (range 0.3 to 12.9). In 28 children with both preoperative and postoperative renal scans, mean preoperative RRF was 20.3 +/- 7.4% and mean postoperative RRF was 20.5 +/- 8.6% with a mean time between renal scans of 2.3 years. No statistically significant change was noted from preoperative to postoperative relative renal function with a mean change of +0.2 +/- 3.7% (range -6.5% to +10%, p=0.82). Postoperative complications occurred in 7 of the 32 children (22%), including hypertension (1), pyelonephritis (3) and persistent reflux (4). Pyelonephritis occurred in 1 child with persistent reflux. No statistically significant difference existed in mean preoperative relative renal function between those with and without complications (24.6 +/- 8.9% vs 18.8 +/- 7.2%, p = 0.09). CONCLUSIONS: Children who underwent ureteral reimplantation in association with unilateral reflux nephropathy maintained stable relative renal function.

Adolescent↗