Comparación entre cistostomía con resección tardía y resección endoscópica aislada en el tratamiento de la válvula de uretra posterior: Un meta-análisis de resultados renales en niños
DOI:
https://doi.org/10.33448/rsd-v14i6.49095Palabras clave:
Válvulas de uretra posterior, Enfermedad renal terminal, Resección endoscópica, Cistostomía, Metaanálisis.Resumen
El objetivo de este estudio fue realizar un metaanálisis para comparar los desenlaces de ERT, medidos por TFG, en niños con VUP tratados con dos estrategias terapéuticas distintas: CT seguida de resección tardía (RT) y REI. Este metaanálisis comparó la cistostomía con resección tardía (CTRT) y la resección endoscópica aislada (REI) para prevenir la enfermedad renal terminal (ERT) en niños con válvulas de uretra posterior (VUP). Se incluyeron 12 estudios (2011–2023) con 770 pacientes, seleccionados tras revisar 1.904 registros. La progresión a ERT fue del 29,28% con CTRT frente al 18,15% con REI, sin diferencia significativa (diferencia absoluta: -11,13%; IC 95%: -33,50% a 11,25%; *p* = 0,306). Ambas técnicas mostraron eficacia similar, con la elección dependiendo de la gravedad de la obstrucción, recursos disponibles y experiencia quirúrgica. La CTRT es viable en entornos con recursos limitados, mientras la REI es preferible en centros especializados. Las limitaciones incluyen heterogeneidad y falta de datos sobre la gravedad de la VUP. Se concluye que la decisión debe ser individualizada, resaltando la necesidad de estudios con seguimiento a largo plazo.
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