临床小儿外科杂志2024，Vol.23Issue(1)：29-34,6.DOI:10.3760/cma.j.cn101785-202311004-006
腹腔镜Lich-Gregoir术与开放Cohen术治疗儿童原发性膀胱输尿管反流的疗效分析
Efficacy comparison of Cohen versus Lich-Gregoir ureteral reimplantation for primary vesicoureteral reflux in children
摘要
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 lap-aroscopic 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 laparo-scopic 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 re-flux,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 hos-pitalization 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 postopera-tive recovery was excellent.Conclusions Laparoscopic Lich-Gregoir and open Cohen surgery are both effica-cious 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.关键词
膀胱输尿管反流/腹腔镜/开放术式/输尿管再植术Key words
Vesicoureteral Reflux/Laparoscope/Open Operation/Ureteral Replantation引用本文复制引用
李宁,张潍平,田军,李明磊,宋宏程,屈彦超..腹腔镜Lich-Gregoir术与开放Cohen术治疗儿童原发性膀胱输尿管反流的疗效分析[J].临床小儿外科杂志,2024,23(1):29-34,6.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)Science & Technology Planning Program of Beijing Municipal Science & Technology Commission and Administrative Commission of Zhongguancun Science Park(Z231100004823034) （Z231100004823034）
