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Laparoscopic vesico-ureteral reimplantation with Lich–Gregoir approach in children: medium term results of 159 renal units in 117 children

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Abstract

Purpose

Vesico-ureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Surgery is an important part of its management. Laparoscopic ureteric reimplantation using the Lich–Gregoir technique is an option for VUR. The aim of this study is to assess short- and medium-term outcomes of this approach.

Materials and methods

This is a retrospective study including all children with VUR treated by laparoscopic extravesical ureteral reimplantation with the Lich–Gregoir technique in University Hospital of Saint-Etienne from August 2007 to May 2016. Surgery was performed after the age of 12 months in cases with repeated urinary tract infection (UTI) and a deterioration of renal function. All patients were followed-up post operatively.

Results

117 children (92 girls, 25 boys) representing 159 renal units were included. The mean age at surgery was 47.1 months (±32.7 months). The mean follow-up was 59.3 months (±31 months). The resolution rate for VUR in terms of no febrile urinary UTIs was 98.3%. The mean operative time was 96 min (±37.7 min) for unilateral procedures and 128 min (±46.1 min) for bilateral procedures. The mean hospital stay was 25.3 h (±6.3 h). There was no difference between males and females regarding age, weight, renal function or follow-up duration.

Conclusions

Laparoscopic reimplantation with Lich–Gregoir technique is an efficient, quick and safe technique for the management of VUR. The success rate is comparable to open techniques with the advantages of laparoscopic approach; this can potentially be performed as a Day Case procedure.

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Authors’ contribution

VS Project development, data collection and management, data analysis manuscript writing and editing AS project development, data management, manuscript writing and editing ML Project development, data collection and management, manuscript editing CYL data analysis manuscript editing ST data analysis manuscript editing SV manuscript editing FV project development, data management, data analysis manuscript writing and editing.

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Authors and Affiliations

  1. Urology Department, University Hospital of Saint Etienne, Avenue Albert Raimond, 42055, Saint Etienne Cedex 2, France

    Victor Soulier & Sodara Thach

  2. Paediatric Surgery Unit, University Hospital of Saint Etienne, Avenue Albert Raimond, 42055, Saint Etienne Cedex 2, France

    Aurélien Scalabre, Manuel Lopez, Sophie Vermersch & François Varlet

  3. FRCS(Urol), University College of London Hospital of London, London, NW12SH, UK

    Chi-Ying Li

Authors
  1. Victor Soulier
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  2. Aurélien Scalabre
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  3. Manuel Lopez
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  5. Sodara Thach
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  7. François Varlet
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Correspondence to Victor Soulier.

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The authors declare that the manuscript has not been submitted to more than one journal for simultaneous consideration. It has not been published previously (party or full). No data have been fabricated or manipulated to support our conclusions. Authors whose names appear on the submission have contributed sufficiently to the scientific work.

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For this type of study (retrospective study), formal consent is not required.

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Soulier, V., Scalabre, A., Lopez, M. et al. Laparoscopic vesico-ureteral reimplantation with Lich–Gregoir approach in children: medium term results of 159 renal units in 117 children. World J Urol 35, 1791–1798 (2017). https://doi.org/10.1007/s00345-017-2064-y

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  • DOI: https://doi.org/10.1007/s00345-017-2064-y

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