Application of abdominal sequential suspension in Laparoscopic Lich-Gregoir procedure for primary vesicoureteral reflux in children

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-01-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.01.013

Fulin Li, Yang Lin, Yongbo Zhang, Jinfeng Li

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Abstract

Objective To explore the safety and efficacy of abdominal sequential suspension in laparoscopic Lich-Gregoir procedure in children with primary vesicoureteral reflux (VUR). Methods From April 2017 to April 2018, clinical data were retrospectively analyzed for 14 children with primary VUR undergoing laparoscopic extravesical reimplantation (Lich-Gregoir technique). Results All children were hospitalized for recurrent urinary tract infection. There were 5 boys and 11 girls with a mean age of 36(9-72) months. The involved side was left (n=6) and right (n=8). Grades Ⅲ (n=3) and Ⅳ/Ⅴ (n=11) of VUR were confirmed by voiding cystourethrography (VCUG). Renal scars were assessed by dimercaptosuccinic acid (DMSA) scan. All laparoscopic Lich-Gregoir operations were successful. The average operative duration was 45(40-62) min and the mean intraoperative blood loss 3.5(2-8) ml. The disappearance of VUR was confirmed by VCUG in all children at 3 months postoperatively, except one with grade I. No reflux occurred on contrast-enhanced ultrasonography at 6 months postoperatively and VCUG at 9 months postoperatively. There was no recent renal scarring or urinary tract infections since then. Conclusions During laparoscopic Lich-Gregoir operation, abdominal sequential suspension can effectively expose surgical field and shorten the operative duration of cutting bladder muscle layer and embedding ureter. Key words: Laparoscopes; Vesicoureteral reflux; Lich-Gergoir; Sequential suspension

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腹腔序贯悬吊在腹腔镜Lich-Gregoir手术治疗儿童原发性膀胱输尿管反流中的应用

目的探讨腹腔镜Lich-Gregoir手术治疗原发性膀胱输尿管反流(VUR)患儿的安全性和有效性。方法回顾性分析2017年4月至2018年4月14例原发性VUR患儿行腹腔镜术外再植(Lich-Gregoir技术)的临床资料。结果所有患儿均因复发性尿路感染住院。男5例，女11例，平均年龄36(9-72)个月。受累侧为左侧(n=6)和右侧(n=8)。通过排尿膀胱尿道造影(VCUG)确认VUR分级Ⅲ(n=3)和Ⅳ/Ⅴ(n=11)。采用二巯基琥珀酸(DMSA)扫描评估肾疤痕。腹腔镜Lich-Gregoir手术均成功。平均手术时间45(40-62)min，平均术中出血量3.5(2-8)ml。除1例i级患儿外，术后3个月所有患儿均行VCUG证实VUR消失，术后6个月超声造影无反流，术后9个月无VCUG。此后再无近期肾瘢痕或尿路感染。结论腹腔镜Lich-Gregoir手术中，腹部序贯悬吊能有效暴露手术视野，缩短切开膀胱肌层、埋置输尿管的手术时间。关键词:腹腔镜;膀胱输尿管的回流;Lich-Gergoir;连续的悬架

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.