STING versus HIT technique of endoscopic treatment for vesicoureteral reflux: A systematic review and meta-analysis.
J Pediatr Surg
; 51(12): 2015-2020, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27773360
ABSTRACT
AIM:
Our study aimed to compare the efficacy of two endoscopic techniques used for the correction of vesicoureteral reflux (VUR) subureteral transurethral injection (STING) and hydrodistension implantation technique (HIT).METHODS:
A systematic review was conducted using MEDLINE, Google scholar, and Cochrane databases from 1984 to 2015. Meta-analysis of the selected studies was performed to compare the extent of reflux resolution following both techniques.RESULTS:
Six observational studies met the inclusion criteria for content. These comprised 632 ureters treated by STING and 895 ureters treated by HIT procedure. All included studies utilized dextranomer/hyaluronic acid (Deflux) as the bulking agent. The overall resolution of VUR was significantly higher in HIT (82.5%) compared to STING (71.4%) [pooled odds ratio (OR)=0.54; 95% confidence interval (CI) 0.42-0.69; P<0.0001; I2=8%]. A subgroup analysis showed that HIT had better outcomes than STING for both lower grade (I-III) [OR=0.43; 95% CI 0.23-0.82; P=0.01; I2=0%] and high-grade VUR (IV-V) [OR=0.43; 95% CI 0.20-0.91; P=0.03; I2=0%]. However, there was no statistical difference in the requirement of additional injections between STING and HIT groups.CONCLUSION:
HIT is superior to STING technique for resolution of VUR after Deflux injection. However, more randomized trials with longer follow-up are necessary to demonstrate the benefit of HIT compared to STING procedure. LEVEL OF EVIDENCE Retrospective comparative studies - level III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Refluxo Vesicoureteral
/
Materiais Biocompatíveis
/
Endoscopia
Tipo de estudo:
Observational_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2016
Tipo de documento:
Article