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The Lich-Gregoir antireflux plasty: experiences with 371 children
Insights
The Lich-Gregoir antireflux procedure effectively treats primary vesicoureteral reflux in children, achieving a 97.7% cure rate with a low complication rate. Surgical correction is recommended when medical therapy fails to resolve reflux and infections.
Area of Science:
- Pediatric Urology
- Surgical Innovation
Background:
- Primary vesicoureteral reflux (VUR) is a common condition in children.
- Recurrent urinary tract infections (UTIs) are a significant concern associated with VUR.
- Conservative management with antimicrobial therapy has limitations.
Purpose of the Study:
- To evaluate the efficacy and safety of the Lich-Gregoir antireflux procedure.
- To determine the success rate and complication profile of the procedure in a large pediatric cohort.
- To establish guidelines for surgical intervention in primary VUR.
Main Methods:
- Retrospective analysis of 371 children undergoing the Lich-Gregoir procedure.
- Inclusion criteria: primary VUR of all grades without gross ureteral dilation.
- Data collection on cure rates, reintervention rates, and complications.
Main Results:
- Successful reflux cure in 97.7% of 429 treated ureters.
- A low incidence of terminal ureter stenosis (0.5%) requiring reimplantation.
- An overall reintervention rate of 3.7%.
Conclusions:
- The Lich-Gregoir procedure is a safe and effective treatment for primary VUR in children.
- Surgical correction is a viable option when medical management fails to eradicate reflux and UTIs within six months.
- The low complication rate supports the recommendation for surgical intervention in select cases.
Abstract:
The Lich-Gregoir antireflux procedure is a simple and safe method for the treatment of primary reflux of all grades if the ureter is not grossly dilated on the excretory urogram. Reflux was cured in 97.7 per cent of 429 ureters in 371 children. A stenosis of the terminal ureter requiring reimplantation occurred in 0.5 per cent. The over-all rate of reinterventions was 3.7 per cent. This low complication rate makes surgical correction of reflux advisable if urinary tract infection and primary reflux cannot be eradicated by continuous antimicrobial therapy within 6 months.