Li Ning,Zhang Weiping,Tian Jun,et al.Efficacy comparison of Cohen versus Lich-Gregoir ureteral reimplantation for primary vesicoureteral reflux in children[J].Journal of Clinical Pediatric Surgery,,():29-34.[doi:10.3760/cma.j.cn101785-202311004-006]
Efficacy comparison of Cohen versus Lich-Gregoir ureteral reimplantation for primary vesicoureteral reflux in children
- Abstract:
- Objective To compare the outcomes of open intravesical versus extravesical procedures for primary vesicoureteral reflux (VUR) in children.Methods From June 2018 to June 2022,150 children of primary VUR were recruited.According to different surgical appraoches,they are divided into two groups of laparoscopic Lich-Gregoir (n=69) and open Cohen (n=81).According to different of VUR sideness,they were assigned into unilateral and bilateral groups.According to whether or not ureter was resected intraoperatively,laparoscopic Lich-Gregoir group was divided into unilateral uncut ureteral laparoscopic Lich-Gregoir group (group A),bilateral uncut ureteral laparoscopic Lich-Gregoir group (group C),unilateral cut ureteral laparoscopic Lich-Gregoir group (group E) and bilateral cut unilateral ureteral laparoscopic Lich-Gregoir group (group G);Open Cohen group was divided into unilateral uncut ureter open Cohen group (group B),bilateral uncut ureter open Cohen group (group D),unilateral cut ureter open Cohen group (group F) and bilateral cut unilateral ureter open Cohen group (group H).Compare the gender,age,symptoms,side profile,degree of reflux,intraoperative and postoperative conditions between two groups of A/B,C/D,E/F and G/H.Results No statistically significant differences existed in gender,age,symptoms,sideness or severity of reflux.Average hospitalization stay for groups A and B was (6.78±1.76) and (10.43±1.25) day;Average hospitalization stay for groups C and D (7.12±2.02) and (11.05±1.82) day;Average hospitalization time for groups E and F (8.83±1.33) and (11.11±1.27) day;Average hospitalization time of groups G and H (8.62±1.59) and (11.46±1.39) day.The inter-group differences were statistically significant (P<0.05).Surgical durations for groups A and B were (78.90±12.54) and (85.60±13.11) min;Surgical durations for groups C and D (89.43±12.37) and (99.55±15.14) min.The inter-group differences were statistically significant (P<0.05).At Months 6-12 post-operation,voiding cystourethrography (VCUG) was re-examined.Seven cases in laparoscopic Lich-Gregoir group and 2 cases in open Cohen group developed high-grade reflux.Among them,two cases underwent laparoscopic Lich-Gregoir re-surgery and seven cases had open Cohen surgery.The postoperative recovery was excellent.Conclusions Laparoscopic Lich-Gregoir and open Cohen surgery are both efficacious for treating primary VUR.Laparoscopic Lich-Gregoir surgery may maintain normal physiological course of ureter and bladder while shorten hospital stay.For patients without intraoperative ureteral cut,laparoscopic Lich-Gregoir may shorten surgical duration.
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Memo
收稿日期:2023-10-30。
基金项目:北京市科委、中关村管委会"医药创新品种及平台培育"专项资助(Z231100004823034)
通讯作者:宋宏程,Email:songhch1975@126.com