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• W2122367691 endingPage "162" @default.
• W2122367691 startingPage "138" @default.
• W2122367691 abstract "Muchas prácticas médicas se continúan realizando sin conocer su efectividad ni el impacto real que tienen en la salud de los pacientes, por lo tanto es necesario fundamentar las recomendaciones profesionales en la evidencia científica. Propósito principal: realizar una revisión sistemática (RS) sobre el manejo terapéutico del reflujo vésico-ureteral primario (RVUP) en urología pediátrica. 1. Definir un tratamiento ideal para cada grado de RVUP, 2. Aclarar incertidumbres sobre diversos aspectos no abordables mediante estudios aislados. Se ha realizado una RS de los artículos aparecidos en todas las bases de datos disponibles, aplicando unos criterios de inclusión y exclusión de calidad mínima imprescindible. Tras la lectura crítica de más de 320 artículos y el estudio estadístico correspondiente de los datos agrupados, según el tipo de tratamiento y beneficios aportados, así como sus efectos indeseables y comparado nuestras conclusiones con las aportadas por el trabajo recogido recientemente en The Chocrane Library, hemos alcanzado las siguientes. El tratamiento médico y el quirúrgico presentan la misma efectividad en la resolución de los grados I, II y III de RVUP, recomendándose el primero de ellos como tratamiento inicial tras el diagnóstico. El manejo endoscópico es igual de efectivo que la cirugía abierta, con menores efectos secundarios, sin haber encontrado diferencias entre las distintas sustancias analizadas para la inyección. Para los reflujos de alto grado IV y V no existen evidencias suficientes que aconsejen o desaconsejen cualquiera de los tratamientos. El tratamiento quirúrgico abierto, para cualquier grado de RVU, sólo presenta superioridad con respecto al tratamiento médico en el número de episodios de pielonefritis aguda durante el seguimiento. Esta afirmación no es posible aplicarla para el tratamiento endoscópico. Many medical practices are being carried out unawares of their efficiency, or of their actual impact on the health of the patients, therefore it is necessary to consider the support of professional recommendations with scientific evidence. to perform a systematic review (SR) of the therapeutic management of primary VUR in pediatric urology. A systematic review has been performed, including scientific evidence-based medicine criteria, of the articles published in all of the available databases. Inclusion criteria concerning basic quality of the articles were considered essential, as well as exclusion criteria to be able to reject the articles. Subsequently, and following the critic reading of greater than 320 articles, statistical study of the grouped data was performed according to the type of treatment and to the benefits contributed by each treatment, and also to their undesirable effects. Finally we have made a comparison between our results and recent Cochrane Systematic Review. The following Conclusions were drawn from the results obtained and from the analysis of the texts. Both medical and surgical treatment present with similar effectiveness concerning resolution of grades I, II and III of VUR, and the former one is the recommended initial treatment following diagnosis. Endoscopic treatment is exactly as effective as open surgery for grades I, II and III with fewer undesirable effects secondary. There are no differences concerning the efficacy of the different injected substances. Not enough evidences exist for degrees IV and V that may recommend or advise against any of the treatments. In any degree of VUR, open surgical treatment is superior as far as medical treatment is concerned only regarding the number of acute pyelonephritis episodes during followup. This conclusion cannot be applied on endoscopic treatment." @default.
• W2122367691 created "2016-06-24" @default.
• W2122367691 creator A5016710293 @default.
• W2122367691 date "2005-01-01" @default.
• W2122367691 modified "2023-10-16" @default.
• W2122367691 title "Tratamiento del reflujo vesico-ureteral primario en la infancia: comparación de dos revisiones sistemáticas" @default.
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