Efficacy of laparoscopic nondismembered Lich-Gregoir ureteral reimplantation for primary vesico-ureteral reflux in children
Objective To evaluate the characteristics and advantages oi laparoscopic nondismembered Lich-Gregoir ureteral replantation for primary vesicoureteral reflux in children.Methods From October 2018 to October 2022,the relevant clinical data were retrospectively reviewed for 31 hospitalized children of primary vesicoureteral reflux(VUR).According to operative approaches,they were assigned into two groups of laparoscopic nondismembered Lich-Gregoir ureteral reimplantation(A,n=17)and gas-bladder Cohen ureteral reimplantation(B,n=14).Based upon the number of affected sides,they were further divided into two groups of unilateral(A1/B1)and bilateral(A2/B2).The parameters of anteroposterior diameter(APD)of renal pelvis were compared before and after surgery and paired sample t-test was employed for statistical processing.Operative duration,intraoperative volume of blood loss and duration of postoperative urinary catheterization were compared.The incidence of such complications as postoperative urinary tract infection,postoperative reflux and postoperative anastomotic obstruction was recorded.Results All operations were successfully completed without any conversion into open surgery.Operative duration was(150.8±12.6)min in A1 group,(178.0±24.9)min in B1 group,(238.8±9.4)min in A2 group and(248.4±9.2)min in B2 group.Average operative duration of group A was less than that of group B and the difference was statistically significant(P＜0.05).APD of renal pelvis values of children with left/right VUR in groups A and B were tested for paired samples before and after surgery and the differences were statistically significant(P＜0.05).Intraoperative volume of blood loss,postoperative duration of hematuria and other values were statistically analyzed and the differences were not statistically significant(P＞0.05).During a follow-up period of(6-36)months,all clinical symptoms were relieved and there was no onset of high-grade reflux.Conclusion Laparoscopic ureteral replantation is efficacious for primary VUR in children.As compared with laparoscopic Cohen ureteral replantation of pneumatocyst,laparoscopic non-dissociative Lich-Gregoir ureteral replantation offers the advantages of shorter operative duration,minimal injury to bladder,fewer postoperative complications and faster postoperative recovery.
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