Abstract
【Abstract】 Objective To explore the clinical experiences of laparoscopic Lich-Gregoir technique in
the treatment of children with primary vesicoureteral reflux (VUR). Methods Clinical data of 30 cases of children with primary VUR in Bayi Children's Hospital, the Seventh Medical Center of PLA General Hospital between September 2009 and September 2015 were analyzed retrospectively. A Trocar (5 mm) was inserted through umbilicus into the abdominal cavity and other 2 trocars (3 or 5 mm) were inserted
through paraumbilical two sides. Electrical surgery unit was used to cut muscular layer. Detrusor tunnel
was approximately 3-5 cm. A foley catheter was inserted for drainage for 3-5 days postoperatively. All
patients were postoperatively followed up with ultrasoundgraphy, diuretic renal dynamic imaging and
urinary excretory cystography. Results The study population consisted of involving 17 male and 13
females, left side 16 cases, right side 10 cases, and bilateral sides 4 cases, 34 sides were noted in all. The
mean age was (39.5±10.2) months (6-144 months). All procedures were completed without conversion to
open surgery. The mean operation time of unilateral ureter were (53±10) min and that of bilateral ureters
were (93±19) min. The mean estimated blood loss was (10±2) ml. Mild hematuria occurred in 3 cases
and disappeared 2-4 d later. All patients had good urination after operation without urinary retention.
One case undertaking bilateral ureteral transplantation was found unilateral VUR grade I , and was
followed up due to no urinary infection, stomachache, fever and other symptoms. The VUR gradeI was disappeared at 30 months after surgery. Conclusions Laparoscopic Lich-Gregoir techniquein the treatment of children with primary VUR is a safe and effective approach, presenting someadvantages including rapid postoperative recovery, original direction of the ureter, minimally invasive,and satisfactory cosmetics
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