was read the article
array:24 [ "pii" => "S217357861930085X" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2019.03.012" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1160" "copyright" => "AEU" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2019;43:439-44" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480619300464" "issn" => "02104806" "doi" => "10.1016/j.acuro.2019.03.003" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1160" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2019;43:439-44" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 46 "formatos" => array:2 [ "HTML" => 27 "PDF" => 19 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Resultados a largo plazo de cirugía antirreflujo vesicoureteral con técnica de Lich-Gregoir sin drenaje vesical" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "439" "paginaFinal" => "444" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Vesicoureteral antireflux surgery with Lich-Gregoir technique without vesical drainage: Long-term results" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2238 "Ancho" => 2087 "Tamanyo" => 224571 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Algoritmo del proceso de selección técnica quirúrgica.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.L. Fadil Iturralde, J. Marani, J.C. Contardi, H.J. Damiani" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J.L." "apellidos" => "Fadil Iturralde" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Marani" ] 2 => array:2 [ "nombre" => "J.C." "apellidos" => "Contardi" ] 3 => array:2 [ "nombre" => "H.J." "apellidos" => "Damiani" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S217357861930085X" "doi" => "10.1016/j.acuroe.2019.03.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357861930085X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480619300464?idApp=UINPBA00004N" "url" => "/02104806/0000004300000008/v1_201910021034/S0210480619300464/v1_201910021034/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173578619300861" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2019.02.009" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1165" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2019;43:445-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Validation of the CUETO scoring model for predicting recurrence and progression in T1G3 urothelial carcinoma of the bladder" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "445" "paginaFinal" => "451" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Validación de las tablas del grupo CUETO para predecir la recurrencia y progresión del carcinoma urotelial de vejiga T1G3" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1637 "Ancho" => 2936 "Tamanyo" => 208807 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">(A–D) Calibration plots for the CUETO model (Red triangles – risk according to CUETO tables; Black diamonds – risk predicted by analysis of our population; Blue squares – actual risk in patients in our population). (A) One-year risk of recurrence. (B) Five-year risk of recurrence. (C) One-year risk of progression. (D) Five-year risk of progression.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "W. Krajewski, O. Rodríguez-Faba, A. Breda, F. Pisano, S. Poletajew, A. Tukiendorf, R. Zdrojowy, A. Kołodziej, J. Palou" "autores" => array:9 [ 0 => array:2 [ "nombre" => "W." "apellidos" => "Krajewski" ] 1 => array:2 [ "nombre" => "O." "apellidos" => "Rodríguez-Faba" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Breda" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Pisano" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Poletajew" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Tukiendorf" ] 6 => array:2 [ "nombre" => "R." "apellidos" => "Zdrojowy" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Kołodziej" ] 8 => array:2 [ "nombre" => "J." "apellidos" => "Palou" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S021048061930066X" "doi" => "10.1016/j.acuro.2019.02.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021048061930066X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578619300861?idApp=UINPBA00004N" "url" => "/21735786/0000004300000008/v1_201910021051/S2173578619300861/v1_201910021051/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173578619300873" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2019.01.011" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1166" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2019;43:431-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Elastic fusion biopsy versus systematic biopsy for prostate cancer detection: Results of a multicentric study on 1119 patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "431" "paginaFinal" => "438" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación de la biopsia de fusión elástica vs. biopsia sistemática para la detección del cáncer de próstata: resultados de un estudio multicéntrico en 1.119 pacientes" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3425 "Ancho" => 2462 "Tamanyo" => 301961 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A: Detection of PCa and csPCa on target plus systematic biopsies (A and B) and on target biopsies only (C and D) and relationship between Gleason score and PI-RADS score (E).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Oderda, G. Marra, S. Albisinni, E. Altobelli, E. Baco, V. Beatrici, M. Dellabella, J.L. Descotes, D. Eldred-Evans, G. Fasolis, M. Ferriero, G. Fiard, A. Giacobbe, P. Kumar, V. Lacetera, P. Mozer, G. Muto, R. Papalia, A. Peltier, T. Piechaud, T. Pierangeli, G. Simone, J.B. Roche, M. Roupret, P. Gontero" "autores" => array:25 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Oderda" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Marra" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Albisinni" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Altobelli" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Baco" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Beatrici" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Dellabella" ] 7 => array:2 [ "nombre" => "J.L." "apellidos" => "Descotes" ] 8 => array:2 [ "nombre" => "D." "apellidos" => "Eldred-Evans" ] 9 => array:2 [ "nombre" => "G." "apellidos" => "Fasolis" ] 10 => array:2 [ "nombre" => "M." "apellidos" => "Ferriero" ] 11 => array:2 [ "nombre" => "G." "apellidos" => "Fiard" ] 12 => array:2 [ "nombre" => "A." "apellidos" => "Giacobbe" ] 13 => array:2 [ "nombre" => "P." "apellidos" => "Kumar" ] 14 => array:2 [ "nombre" => "V." "apellidos" => "Lacetera" ] 15 => array:2 [ "nombre" => "P." "apellidos" => "Mozer" ] 16 => array:2 [ "nombre" => "G." "apellidos" => "Muto" ] 17 => array:2 [ "nombre" => "R." "apellidos" => "Papalia" ] 18 => array:2 [ "nombre" => "A." "apellidos" => "Peltier" ] 19 => array:2 [ "nombre" => "T." "apellidos" => "Piechaud" ] 20 => array:2 [ "nombre" => "T." "apellidos" => "Pierangeli" ] 21 => array:2 [ "nombre" => "G." "apellidos" => "Simone" ] 22 => array:2 [ "nombre" => "J.B." "apellidos" => "Roche" ] 23 => array:2 [ "nombre" => "M." "apellidos" => "Roupret" ] 24 => array:2 [ "nombre" => "P." "apellidos" => "Gontero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480619300671" "doi" => "10.1016/j.acuro.2019.01.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480619300671?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578619300873?idApp=UINPBA00004N" "url" => "/21735786/0000004300000008/v1_201910021051/S2173578619300873/v1_201910021051/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Vesicoureteral antireflux surgery with Lich–Gregoir technique without vesical drainage: Long-term results" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "439" "paginaFinal" => "444" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.L. Fadil Iturralde, J. Marani, J.C. Contardi, H.J. Damiani" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.L." "apellidos" => "Fadil Iturralde" "email" => array:1 [ 0 => "jlfi68@yahoo.com.ar" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Marani" ] 2 => array:2 [ "nombre" => "J.C." "apellidos" => "Contardi" ] 3 => array:2 [ "nombre" => "H.J." "apellidos" => "Damiani" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Urología Pediátrica, Hospital Municipal de Niños Víctor J. Vilela, Rosario, Provincia de Santa Fe, Argentina" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resultados a largo plazo de cirugía antirreflujo vesicoureteral con técnica de Lich-Gregoir sin drenaje vesical" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2238 "Ancho" => 2087 "Tamanyo" => 226750 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Algorithm showing the selection process of the surgical technique.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">There are several surgical techniques for the correction of pediatric vesicoureteral reflux (VUR), either through open surgical, laparoscopic, robot-assisted approach or endoscopic subureteral injection of bulking agents.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Endoscopic treatment is currently considered the first choice for the treatment of VUR, as it is minimally invasive, and it can be performed as an outpatient procedure. However, conventional surgery arises in those cases when it cannot be achieved due to certain circumstances.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Open surgical techniques have an effectiveness close to 95–98%,<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1,2</span></a> with a low rate of complications. Extravesical reimplantation with the Lich–Gregoir technique and its modified variants have the same outcomes as transvesical procedures, but with less pain, almost without bladder spasms or hematuria and with faster recovery.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">3–9</span></a> However, its application is still under consensus as it is associated with voiding dysfunction and due to the requirement of postoperative vesical drainage. Laparoscopic and robot-assisted techniques have not yet proved to be beneficial for the patients.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We describe our experience in the management of patients with VUR, who underwent extravesical reimplantation without postoperative vesical drainage, evaluating its immediate, short and long-term evolution.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and method</span><p id="par0025" class="elsevierStylePara elsevierViewall">A retrospective review of the data of patients operated at the Víctor J. Vilela Children's Hospital and at the Children's Sanatorium in the city of Rosario, Argentina; between January 2010 and December 2013. These patients underwent modified extraperitoneal ureterovesical reimplantation of Lich–Gregoir for the treatment of VUR, without the use of vesical drainage in the postoperative period.</p><p id="par0030" class="elsevierStylePara elsevierViewall">All patients were evaluated prior to surgical indication in the Urology and Nephrology Departments through laboratory tests, ultrasound, serial voiding cystourethrography (VCUG) and dimercaptosuccinic acid renal scintigraphy.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Surgical correction with extravesical reimplantation was indicated to patients with some of the following features, in addition to the lack of access for endoscopic treatment:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">–</span><p id="par0040" class="elsevierStylePara elsevierViewall">Presence of primary vesicoureteral reflux grade <span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">V</span> in patients older than 6 years.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">–</span><p id="par0045" class="elsevierStylePara elsevierViewall">VUR (any grade) with recurrent urinary infections under antibiotic prophylaxis.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">–</span><p id="par0050" class="elsevierStylePara elsevierViewall">Impaired renal function.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">–</span><p id="par0055" class="elsevierStylePara elsevierViewall">Absence of voiding dysfunction.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">–</span><p id="par0060" class="elsevierStylePara elsevierViewall">Parental preferences for open surgery.</p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">This technique was not performed in patients with secondary VUR, male patients with bilateral reflux, refluxing and/or obstructing megaureter, non-toilet trained children. Moreover, patients who presented involuntary contractions of the bladder mucosa during the reconstruction of the submucosal tunnel were excluded from the study, with mandatory vesical drainage. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> summarizes the algorithm used in the selection process of the surgical technique.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The analized variables were age, sex, reflux grade, indication for surgery, operative time, hospital stay and results in the short, medium and long term (5 years).</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intraoperative management</span><p id="par0075" class="elsevierStylePara elsevierViewall">All patients were treated by general anesthesia without caudal block and operated by the same group of surgeons, following the technique described in the literature. Diclofenac was used as intraoperative analgesic.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Surgical technique</span><p id="par0080" class="elsevierStylePara elsevierViewall">A small Pfannenstiel incision was made. The lateral face of the bladder was approached in order to mobilize it. The obliterated umbilical artery was identified (excellent reference point to recognize the ureter) but not dissected, and ureterolysis was always performed distal and lateral to it. The peritoneum was carefully retracted from the surface of the ureter. To avoid injuring the branches of the pelvic plexus, it was dissected close to the ureteral adventitia and the use of electrocautery was minimized. The ureter is liberated at its entry into the bladder without disrupting its continuity. The future course of the ureter along the posterior bladder wall was chosen and signaled at a distance of 3–5<span class="elsevierStyleHsp" style=""></span>cm, according to the diameter of the ureter (following the 5:1 ratio). The detrusor was incised with fine tip electrocautery, low intensity needle (less than 20<span class="elsevierStyleHsp" style=""></span>W), and it was opened by blunt dissection until the mucosal protrusion was observed uniformly, creating the new submucosal tunnel. The ureter was placed on it and the detrusor reapproximated using interrupted 3-0 polyglactin sutures. Advancing suture to the meatus was not performed, nor the ureter was fixed to the detrusor. Once the suture line was completed, the size of the hiatus was verified with a right-angle clamp to avoid constriction of the ureter. At the end of the procedure, the bladder was emptied by direct needle (25/8) puncture and the surgical wound was infiltrated with 0.25% bupivacaine. There was neither instrumentation nor catheter insertion into the urethra during the operation.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Postoperative management</span><p id="par0085" class="elsevierStylePara elsevierViewall">The patients were discharged to the general ward, with basal parenteral hydration and diclofenac until oral tolerance, followed by oral analgesia with ibuprofen (8<span class="elsevierStyleHsp" style=""></span>mg/kg/dose, 3 times a day) or paracetamol (15<span class="elsevierStyleHsp" style=""></span>mg/mg/kg/dose, 3–4 times a day). Early ambulation and regulated voindings were stimulated every 2–3<span class="elsevierStyleHsp" style=""></span>h. The placement of a bladder catheter was indicated in those cases in which spontaneous voiding was not achieved, or in those patients who presented distended bladder or urinary incontinence.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Those patients who tolerated oral intake, felt comfortable with oral analgesics, had at least 2 spontaneous micturitions without distended bladder or urinary incontinence, walked without problems, and his/her parents felt confident, were discharged from hospital with specific written instructions and were called for a follow-up visit at 72<span class="elsevierStyleHsp" style=""></span>h.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Subsequently, continuous outpatient follow-up was performed including evaluation of clinical symptoms, complete urine analysis and ultrasound at 1, 3, 6, 12 months and anually thereafter until the 5th year after surgery. VCUG was requested in those cases presenting hydronephrosis, episodes of recurrent or febrile urinary infection, or at parental request.</p><p id="par0100" class="elsevierStylePara elsevierViewall">All the data were transferred into a spreadsheet and analyzed with the SPSS IBM<span class="elsevierStyleSup">®</span> statistical system (IBM Statistics 23.0).</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">After analyzing the clinical history of 58 patients who had been submitted to surgery following Lich–Gregoir technique without postoperative vesical drainage, we selected 45 patients who had a follow-up of 5 years or more. Thirty-seven women (82.2%) and 8 men (17.8%), with 62 renal units had undergone surgery. Twenty-eight patients with unilateral reflux and 17 patients with bilateral reflux. Five patients with unilateral reflux had duplex excretory system (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The mean age of the population was 6 years, ranging from 2 to 11 years.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The most frequent indication for surgery was the persistence of reflux in patients older than 6 years, 33 cases (73.3%); followed by the presence of recurrent urinary infections even under prophylaxis in 6 patients (13.3%); impaired renal function (8.9%), and 2 patients (4.4%) by parental preferences to discontinue antibiotic therapies and resolve reflux. These data are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The distribution of the different grades of VUR is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>, with grade III VUR (75.6%) being the most frequent, followed by grade IV with 7 patients (15.6%); grade II with 3 patients (6.7%), and only one patient grade V. Patients with bilateral VUR were classified according to the side with the highest grade.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The mean operation time was 44<span class="elsevierStyleHsp" style=""></span>min (35–70) for unilateral reimplantation and 70<span class="elsevierStyleHsp" style=""></span>min (53–98) for bilateral reimplantation.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Strict control of diuresis was performed in the immediate postoperative period. All patients presented spontaneous voiding after the surgical intervention without presenting pain, hematuria, incontinence or distended bladder on abdominal palpation.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Hospital discharge took place between 7 and 36<span class="elsevierStyleHsp" style=""></span>h postoperatively (mean 11<span class="elsevierStyleHsp" style=""></span>h). Regarding this aspect, we must mention that 31 children (68.9) were discharged on the same day, while the remaining 14 (31.1) were dismissed the day after surgery due to administrative issues. None of the patients had to be rehospitalized.</p><p id="par0135" class="elsevierStylePara elsevierViewall">All patients had a follow-up visit within the 72<span class="elsevierStyleHsp" style=""></span>h of the postoperative period to confirm the presence of spontaneous voiding and the absence of distended bladder. There were 6 cases with suspicion of distended bladder which was subsequently ruled out by ultrasound. At that time, patients discontinued taking analgesics and started prophylaxis which lasted for the first postoperative month. There were no cases of hematuria or urinary infection during the immediate postoperative period.</p><p id="par0140" class="elsevierStylePara elsevierViewall">The ultrasound performed at the first month of POP showed 7 renal units (2 from bilateral reimplantation), with mild renal pelvis dilatation in the absence of ureteral dilatation. All patients had post-void residual volume which was lower than 10% of the pre-void volume. The resolution of ectasia was shown by ultrasound at the third postoperative month. Subsequently, they continued with the ultrasound controls as detailed above, with satisfactory results and without post-void residual.</p><p id="par0145" class="elsevierStylePara elsevierViewall">There were no patients presenting voiding dysfunction, thus urodynamic studies were not required.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Regarding the clinical evolution of these patients, 8 of them presented episodes of urinary infections during the 5-year follow-up. Five patients were diagnosed with at least one episode of cystitis, and 3 patients presented febrile urinary infections. VCUG was requested only in these cases, with one case of grade I VUR in the contralateral renal unit. None of the operated units presented VUR.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">Lich et al. (1961, USA) and Gregoir (1964, Europe) separately described the extravesical approach to ureteral reimplantation. The main advantages of this technique are that hematuria and postoperative bladder spasms are reduced (for it does not require bladder opening), thus minimizing the patient's hospital stay. Despite this, its performance is still under debate due to the possible onset of voiding dysfunction, which in some cases requires catheterization for several weeks.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">3,4,10</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Different modifications of the initial technique arose with the purpose of reducing its incidence. Daines and Hodgson (1971), as well as Zaontz (1987) advocated that fixation of the ureter with advancing sutures and minimal release of the ureter were sufficient to decrease the risk of voiding dysfunction.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> However, Leissner et al., in 2001, marked an important milestone in the prevention of voiding dysfunction after extravesical reimplantation, with a detailed recognition of the pelvic plexus. Neuropraxia can be reduced upon greater knowledge of the topography of the main neural elements, located at 1.5–2<span class="elsevierStyleHsp" style=""></span>cm superior/dorsal to the bladder trigone and medial/dorsal to the ureter.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">The usual 3–7-day hospital stay of antireflux surgeries evolved to surgeries with 1-day hospital stay, achieving ambulatory procedures resulting from greater anatomical knowledge of the surgeons, smaller incisions, shorter operative time, better management of anesthesia and analgesics, and the avoidance of urethral catheters.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">2,12–18</span></a> These advances are in line with the current goals in medical care, aimed at minimizing hospital stay and costs without compromising the results and quality of life of the patients.</p><p id="par0170" class="elsevierStylePara elsevierViewall">In our series, unilateral reimplantation was performed to both sexes, but only to girls with bilateral reflux. This selection is based on 2 circumstances: men have greater urethral resistance, and we believe this could be a factor that increases the possibility of presenting urinary retention. In addition, if urethral catheterization was required in the postoperative period, this could be more traumatic for the child and his family. However, this decision is not based upon scientific evidence.</p><p id="par0175" class="elsevierStylePara elsevierViewall">The presence of duplex excretory system did not affect our indication, being the ureteral release somewhat more difficult but conceivable, without repercussions in the evolution or success of the treatment.</p><p id="par0180" class="elsevierStylePara elsevierViewall">Although cystoscopy was not performed, the presence of diverticula, ureterocele or refluxing/obstructing megaureter were exclusion criteria, since a correct cystourethrogram and the high definition of the current ultrasound equipment provided us with enough information.</p><p id="par0185" class="elsevierStylePara elsevierViewall">The patients were operated under general anesthesia, avoiding the use of opioid medications. Some authors proclaim the usefulness of caudal blocks in this type of procedure, but these were not administered to our patients. A small Pfannenstiel incision, associated with infiltration with bupivacaine in the surgical area, contributed for an adequate postoperative pain management.</p><p id="par0190" class="elsevierStylePara elsevierViewall">Transient voiding dysfunction has been described in up to 20% of children in whom bilateral ureteral reimplantation is performed, but not in unilateral extravesical procedures.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> We included 17 girls with bilateral reimplantation in our series with no clinical evidence of voiding dysfunction. It is produced by nerve damage during detrusorectomy and ureterolysis, and this is why we limit the dissection to the correct plane (just outside the ureteral adventitia), always distal to the obliterated umbilical artery, without dissecting it. We also reduced the use and power of electrocautery, restricted the incision of the distal detrusor to the ureterovesical junction and gently manipulated the tissues during bladder retraction.</p><p id="par0195" class="elsevierStylePara elsevierViewall">Bladder overdistension and urethral pain due to perioperative instrumentation are predisposing factors for urinary retention in the postoperative period. Aiming to reduce its incidence, we emptied the bladder by puncture under direct vision following reimplantation, without instrumentation of the urethra. Additionally, parenteral hydration was indicated to avoid rapid bladder filling during the first hours of postoperative recovery.</p><p id="par0200" class="elsevierStylePara elsevierViewall">Although there is evidence that justifies the placement of urethral catheter for 24–48<span class="elsevierStyleHsp" style=""></span>h during the postoperative period,<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">10,12,13</span></a> some authors such as Marotte and Smith,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> do not recommend its use. We agree with them in our series. The lack of urethral catheter mitigates bladder spasms, thus minimizing the need for analgesics, and avoids the use of anticholinergics. Early ambulation and periodic voiding have positive impacts on the prevention of urinary retention.</p><p id="par0205" class="elsevierStylePara elsevierViewall">In order to achieve this, the nursing staff in charge, as well as the parents of the patients, must be well instructed. This is why our series did not include patients without sphincter control or with parents who could not understand the importance of micturition regulation.</p><p id="par0210" class="elsevierStylePara elsevierViewall">The evaluation of surgical success in this work is controversial. We did not perform a VCUG in our series because we considered that the clinical evolution of the patients was enough to determine therapeutic success.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> Eight patients presented urinary tract infection during follow-up, and only patient presented grade I VUR in the contralateral renal unit in the VCUG result. It is lower than the data reported in the literature which ranges from 5 to 30%, but it can be due to selection bias.</p><p id="par0215" class="elsevierStylePara elsevierViewall">The most remarkable aspect of this work is that it allowed us to describe the evolution of this group of patients with a minimum follow-up of 5 years, certifying in some way the long-term efficacy and safety of the ureteral reimplantation with extravesical technique, without the placement of postoperative vesical drainage. On the contrary, since it is a retrospective study of clinical cases in a selected population, it does not perform case control comparisons. In addition to this, and considering that in our service we only request VCUG in the presence of hydronephrosis or urinary tract infections, there was not a diagnostic method that allowed us to objectively certify the success of the reimplantation.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusion</span><p id="par0220" class="elsevierStylePara elsevierViewall">We ascribe the very good results to the meticulous selection of the patients, as well as to the detailed surgical gestures, performing a minimum dissection of the detrusor and the distal ureter with minor use of electrocautery. The emptying of the bladder without instrumentation of the urethra, in addition to a correct use of analgesics and an early ambulation, have a positive impact on voiding function and postoperative urinary retention, shortening the hospital stay and increasing the patient's well-being. The 5-year follow-up also demonstrates the long-term safety of the procedure.</p><p id="par0225" class="elsevierStylePara elsevierViewall">We hope that our experience encourages the performance of prospective double-blind studies that confirm these results.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicts of interest</span><p id="par0230" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1251581" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1160303" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1251582" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1160302" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and method" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Intraoperative management" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Surgical technique" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Postoperative management" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-01-15" "fechaAceptado" => "2019-03-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1160303" "palabras" => array:5 [ 0 => "Vesicoureteral reflux" 1 => "Ureteral reimplantation" 2 => "Lich–Gregoir" 3 => "Ambulatory" 4 => "Bladder catheter" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1160302" "palabras" => array:5 [ 0 => "Reflujo vesicoureteral" 1 => "Reimplante ureteral" 2 => "Lich-Gregoir" 3 => "Ambulatorio" 4 => "Sonda vesical" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To describe our long-term experience with patients with vesicoureteral reflux (VUR) who underwent conventional surgery without postoperative bladder drainage.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective review of 45 patients surgically treated by extravesical Lich–Gregoir's ureterovesical reimplantation without postoperative bladder drainage between 2010 and 2013.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">37 women (82.2%) and 8 men (17.8%). 28 patients with unilateral reflux, and 17 patients with bilateral reflux with a total of 62 operated kidneys. The mean age at surgery was 6 years (2–11 years).</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The main cause of surgical indication was the persistence of reflux in patients older than 6 years (73.3%); with grade <span class="elsevierStyleSmallCaps">III</span> VUR (75.6%) being the most frequent. The mean surgical time was 44<span class="elsevierStyleHsp" style=""></span>min (35–70) for unilateral reimplantation, and 70<span class="elsevierStyleHsp" style=""></span>min (53–98) for bilateral ones.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">All patients presented spontaneous urination in the immediate postoperative period, without pain, no hematuria, full incontinence, and without a bladder balloon. None required bladder catheter placement, and hospital discharge was indicated between 7 and 36<span class="elsevierStyleHsp" style=""></span>h postoperatively (mean 11<span class="elsevierStyleHsp" style=""></span>h).</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">All continued with spontaneous micturitions, without postvoid residual or voiding dysfunction during the 5-year follow-up.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The thorough selection of the patients, the detailed surgical gestures, the bladder emptying without instrumentation of the urethra, together with a correct use of analgesics and early ambulation allowed excellent outcomes obtained in these patients managed with a short hospital stay and without bladder drainage, also demonstrating the safety of the procedure at 5 years of follow-up.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Describir nuestra experiencia a largo plazo de pacientes portadores de reflujo vesicoureteral (RVU) operados a cielo abierto sin drenaje vesical postoperatorio.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y método</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Revisión retrospectiva de 45 pacientes intervenidos quirúrgicamente durante el periodo 2010-2013, a quienes se les realizó reimplante ureterovesical extraperitoneal tipo Lich-Gregoir por vía convencional, sin drenaje vesical durante el postoperatorio.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Treinta y siete mujeres (82,2%) y 8 varones (17,8%), con 62 unidades renales operadas. Veintiocho pacientes con reflujo unilateral y 17 pacientes con reflujo bilateral. La edad media en el momento de la cirugía fue de 6 años (2 a 11 años).</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">La principal causa de indicación quirúrgica fue la persistencia del reflujo en paciente mayor a 6 años (73,3%), siendo el RVU grado <span class="elsevierStyleSmallCaps">iii</span> (75,6%) el más frecuente. El tiempo quirúrgico medio fue de 44 min (35-70) para los reimplantes unilaterales y de 70 min (53-98) para los bilaterales.</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes presentaron micciones espontáneas en el postoperatorio inmediato, sin dolor, sin hematuria, sin incontinencia y sin globo vesical. Ninguno requirió colocación de sonda vesical y se indicó alta hospitalaria entre las 7 y 36 h del postoperatorio (media 11<span class="elsevierStyleHsp" style=""></span>h).</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Todos continuaron con micciones espontáneas, sin residuo posmiccional ni disfunción miccional en los 5 años de seguimiento.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">La selección minuciosa de los pacientes, lo detallista de los gestos quirúrgicos, el vaciado vesical sin instrumentación de la uretra, sumado a un correcto uso de analgésicos y a la deambulación temprana, permitieron obtener excelentes resultados en estos pacientes manejados con una corta estancia hospitalaria y sin drenaje vesical, demostrando además la seguridad del procedimiento a 5 años de seguimiento.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fadil Iturralde JL, Marani J, Contardi JC, Damiani HJ. Resultados a largo plazo de cirugía antirreflujo vesicoureteral con técnica de Lich-Gregoir sin drenaje vesical. Actas Urol Esp. 2019;43:439–444.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2238 "Ancho" => 2087 "Tamanyo" => 226750 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Algorithm showing the selection process of the surgical technique.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Age range in parentheses.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">N.° of patients</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age (years), mean</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 years (2–11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex (%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (82.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (17.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Unilateral reimplantations (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (62.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Bilateral reimplantations (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (37.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Duplex collecting system (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (11.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2141156.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Patients’ characteristics.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cause/surgical indication \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Persistent reflux<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>6 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urinary infections under prophylaxis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Impaired renal function \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Parental preferences \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2141155.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Surgical indication of the studied population.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grade \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percentage \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSmallCaps">II</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSmallCaps">III</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSmallCaps">IV</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleSmallCaps">V</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2141154.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Reflux grade of the studied population.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vesicoureteral reflux: surgical and endoscopic treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Capozza" 1 => "P. Caione" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00467-006-0415-9" "Revista" => array:6 [ "tituloSerie" => "Pediatr Nephrol" "fecha" => "2007" "volumen" => "22" "paginaInicial" => "1261" "paginaFinal" => "1265" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17277953" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0110" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extravesical ureteral reimplantations for the correction of primary reflux can be done as outpatient procedures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.B. Marotte" 1 => "D.P. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00005392-200106001-00003" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2001" "volumen" => "165" "paginaInicial" => "2228" "paginaFinal" => "2231" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11371950" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0115" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recurrent urosepsis in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Lich Jr." 1 => "L.W. Howerton" 2 => "L.A. Davis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Urol" "fecha" => "1961" "volumen" => "86" "paginaInicial" => "554" "paginaFinal" => "558" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0120" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Le traitement chirurgical du reflux vesico-ureteral congenital" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W. Gregoir" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Acta Chir Belg" "fecha" => "1964" "volumen" => "63" "paginaInicial" => "431" "paginaFinal" => "439" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14197630" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022399917310954" "estado" => "S300" "issn" => "00223999" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0125" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extravesical antirefluxplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W. Gregoir" 1 => "C.C. Schulman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Urologe A" "fecha" => "1977" "volumen" => "16" "paginaInicial" => "124" "paginaFinal" => "1247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/327648" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0130" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extravesical nondismembered ureteroplasty with detrusorrhaphy: a renewed technique to correct vesicoureteral reflux in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.M. Houle" 1 => "G.A. McLorie" 2 => "D.M. Heritz" 3 => "P.H. McKenna" 4 => "B.M. Churchill" 5 => "A.E. Khoury" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0022-5347(17)36699-5" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1992" "volumen" => "148" "paginaInicial" => "704" "paginaFinal" => "707" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1640551" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0135" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ureteral reimplantation: postoperative management without catheters" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.A. Brandell" 1 => "J.W. Brock" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0090-4295(93)90539-m" "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "1993" "volumen" => "42" "paginaInicial" => "705" "paginaFinal" => "707" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8256404" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0140" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nerve sparing extravesical repair of bilateral vesicoureteral reflux: description of technique and evaluation of urinary retention" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. David" 1 => "C. Kelly" 2 => "D.P. Poppas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ju.0000139951.37492.91" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2004" "volumen" => "172" "paginaInicial" => "1617" "paginaFinal" => "1620" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15371774" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0145" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detrusorrhaphy: extravesical ureteral advancement to correct vesicoureteral reflux in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.R. Zaontz" 1 => "M. Maizels" 2 => "E.C. Sugar" 3 => "C.F. Firlit" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0022-5347(17)43466-5" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "1987" "volumen" => "138" "paginaInicial" => "947" "paginaFinal" => "949" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3656576" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0150" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Can standard open pediatric urological procedures be performed on an outpatient basis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.K. Sprunger" 1 => "C.T. Reese" 2 => "R.M. Decter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2001" "volumen" => "166" "paginaInicial" => "1062" "paginaFinal" => "1064" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11490300" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0155" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The pelvic plexus and antireflux surgery: topographical findings and clinical consequences" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Leissner" 1 => "E.P. Allhoff" 2 => "W. Wolff" 3 => "C. Feja" 4 => "M. Hockel" 5 => "P. Black" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2001" "volumen" => "165" "paginaInicial" => "1652" "paginaFinal" => "1655" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11342948" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0160" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unilateral extravesical ureteral reimplantation in children performed on an outpatient basis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Putman" 1 => "C. Wicher" 2 => "R. Wayment" 3 => "B. Harrell" 4 => "C. Devries" 5 => "B. Snow" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ju.0000176795.96815.43" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2005" "volumen" => "174" "paginaInicial" => "1987" "paginaFinal" => "1989" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16217374" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0165" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early hospital discharge for intravesical ureteroneocystostomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "O.F. Miller" 1 => "T.L. Bloom" 2 => "L.J. Smith" 3 => "I.M. McAleer" 4 => "G.W. Kaplan" 5 => "T.F. Kolon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2002" "volumen" => "167" "paginaInicial" => "2556" "paginaFinal" => "2559" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11992088" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0170" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk of detrusor denervation in antireflux surgery demonstrated in a neurophysiological animal model" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.J. Martınez Portillo" 1 => "C. Seif" 2 => "P.M. Braun" 3 => "G. Böhler" 4 => "D.K. Osmonov" 5 => "J. Leissner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ju.0000077446.49441.a9" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2003" "volumen" => "170" "paginaInicial" => "570" "paginaFinal" => "574" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12853833" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0175" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ureteroneocystostomy without urethral catheterization shortens hospital stay without compromising postoperative success" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.T. Duong" 1 => "D.J. Parekh" 2 => "J.C. Pope" 3 => "M.C. Adams" 4 => "J.W. Brock" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ju.0000084144.50541.3d" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2003" "volumen" => "170" "paginaInicial" => "1570" "paginaFinal" => "1573" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14501663" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0180" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bilateral extravesical ureteral reimplantation in toilet trained children: is 1-day hospitalization without urinary retention possible?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.E. McAchran" 1 => "J.S. Palmer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ju.0000176490.42169.ee" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2005" "volumen" => "174" "paginaInicial" => "1991" "paginaFinal" => "1993" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16217375" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0185" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mini-ureteroneocystostomy: a safe and effective outpatient treatment for unilateral vesicoureteral reflux" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Ashley" 1 => "D. Vandersteen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2008.04.081" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2008" "volumen" => "180" "paginaInicial" => "1621" "paginaFinal" => "1625" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18708210" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0190" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extravesical ureteral reimplantation: an outpatient procedure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.S. Palmer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.juro.2008.04.080" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2008" "volumen" => "180" "paginaInicial" => "1828" "paginaFinal" => "1831" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18721936" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0195" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reflujo vesicoureteral esencial y reimplantación ureteral extravesical en niños" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. García Mérida" 1 => "R. Gosalbez Jr." 2 => "F. Rius Diaz" 3 => "A. Labbie" 4 => "M. Castellan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0210-4806(06)73501-x" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2006" "volumen" => "30" "paginaInicial" => "602" "paginaFinal" => "609" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16921838" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0200" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are postoperative studies justified after extravesical ureteral reimplantation?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Barrieras" 1 => "S. Lapointe" 2 => "P.P. Reddy" 3 => "P. Williot" 4 => "G.A. McLorie" 5 => "D. Babli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00005392-200009020-00035" "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2000" "volumen" => "164" "paginaInicial" => "1064" "paginaFinal" => "1066" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10958758" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000004300000008/v1_201910021051/S217357861930085X/v1_201910021051/en/main.assets" "Apartado" => array:4 [ "identificador" => "6274" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000004300000008/v1_201910021051/S217357861930085X/v1_201910021051/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357861930085X?idApp=UINPBA00004N" ]
Year/Month | Html | Total | |
---|---|---|---|
2023 March | 1 | 2 | 3 |
2020 April | 1 | 0 | 1 |