{"title":"Lich-Gregoir vs. Cohen ureteral re-implantation surgery for bilateral vesicoureteral reflux: A propensity score analysis.","authors":"Takayuki Fujii, Hiroyuki Satoh, Atsuko Sato, Yoshiaki Ishizuka, Mizuki Izawa, Yuki Morimoto, Ryuichi Shimono","doi":"10.1111/ped.70010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Lich-Gregoir procedure for bilateral vesicoureteral reflux (VUR) is limited by the risk of urinary retention. Here, we investigated the efficacy of the Lich-Gregoir procedure compared to that of the Cohen procedure for bilateral VUR in children.</p><p><strong>Methods: </strong>We retrospectively evaluated children who underwent open ureteral re-implantation for bilateral VUR between 2010 and 2022. The patients' clinical characteristics and perioperative outcomes were compared after 1:1 propensity score matching (PSM).</p><p><strong>Results: </strong>A total of 137 patients were enrolled in this study, with 122 undergoing the Cohen procedure and 15 undergoing the Lich-Gregoir procedure. After PSM, there were 14 patients in each group. The operative time was shorter in the Lich-Gregoir group (121.0 vs. 157.0 min; p = 0.018), while the urethral Foley stay was longer in the Cohen group (6.0 vs. 4.0 days; p < 0.001). Only the Cohen group required ureteral catheter insertion (4.5 days) and had a higher rate of bladder spasms (85.7% vs. 0%; p < 0.001). The Cohen group experienced two postoperative complications, while the Lich-Gregoir group had one patient with temporary urinary retention. The hospitalization period was longer in the Cohen group (8.0 vs. 7.0 days; p < 0.001). There were no significant differences in postoperative hydronephrosis, postoperative urinary tract infection, and persistent VUR between the two groups.</p><p><strong>Conclusions: </strong>The Lich-Gregoir procedure for bilateral VUR was safely and effectively performed in patients who met several criteria (e.g., toilet-trained patients, mild-to-moderate reflux, and normal bladder volume and function).</p>","PeriodicalId":20039,"journal":{"name":"Pediatrics International","volume":"67 1","pages":"e70010"},"PeriodicalIF":1.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatrics International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ped.70010","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The Lich-Gregoir procedure for bilateral vesicoureteral reflux (VUR) is limited by the risk of urinary retention. Here, we investigated the efficacy of the Lich-Gregoir procedure compared to that of the Cohen procedure for bilateral VUR in children.
Methods: We retrospectively evaluated children who underwent open ureteral re-implantation for bilateral VUR between 2010 and 2022. The patients' clinical characteristics and perioperative outcomes were compared after 1:1 propensity score matching (PSM).
Results: A total of 137 patients were enrolled in this study, with 122 undergoing the Cohen procedure and 15 undergoing the Lich-Gregoir procedure. After PSM, there were 14 patients in each group. The operative time was shorter in the Lich-Gregoir group (121.0 vs. 157.0 min; p = 0.018), while the urethral Foley stay was longer in the Cohen group (6.0 vs. 4.0 days; p < 0.001). Only the Cohen group required ureteral catheter insertion (4.5 days) and had a higher rate of bladder spasms (85.7% vs. 0%; p < 0.001). The Cohen group experienced two postoperative complications, while the Lich-Gregoir group had one patient with temporary urinary retention. The hospitalization period was longer in the Cohen group (8.0 vs. 7.0 days; p < 0.001). There were no significant differences in postoperative hydronephrosis, postoperative urinary tract infection, and persistent VUR between the two groups.
Conclusions: The Lich-Gregoir procedure for bilateral VUR was safely and effectively performed in patients who met several criteria (e.g., toilet-trained patients, mild-to-moderate reflux, and normal bladder volume and function).
期刊介绍:
Publishing articles of scientific excellence in pediatrics and child health delivery, Pediatrics International aims to encourage those involved in the research, practice and delivery of child health to share their experiences, ideas and achievements. Formerly Acta Paediatrica Japonica, the change in name in 1999 to Pediatrics International, reflects the Journal''s international status both in readership and contributions (approximately 45% of articles published are from non-Japanese authors). The Editors continue their strong commitment to the sharing of scientific information for the benefit of children everywhere.
Pediatrics International opens the door to all authors throughout the world. Manuscripts are judged by two experts solely upon the basis of their contribution of original data, original ideas and their presentation.