[Anti-reflux operations in children with primary vesico-renal reflux]

Antireflux operations after the Grégoir-Lich technic was performed in 50 children on 72 ureters; resection of the distal ureteral portion with neoimplantation after the Politano-Leadbetter technic was accomplished in 31 patients on 46 ureters; nephroureterectomy-in 4 patients due to destruction of the organ. Morphological studies of 50 by the defect in development of muscles of the distal ureteral portion (diffuse, hyperplasia of muscle bundles, focal or segmental underdevelopment of muscles, etc). In insignificant muscle hypoplasia chronic inflammation resulting in sclerosis is of major importance for pathogenesis of insufficiency of the uretero-vesical segment. The changes described are manifested in the clinico-roentgenological picture of the disease. In reflux, grade III-IV, according to the R. A. Bridge and C. W. Roe classification resection and neoimplantation of the ureter after the Politano-Leadbetter technic seem to be indicated; in grade II antireflux Grégoir-Lich surgery may be performed.