PMID- 19746335
OWN - NLM
STAT- MEDLINE
DCOM- 20100119
LR  - 20141120
IS  - 1439-359X (Electronic)
IS  - 0939-7248 (Linking)
VI  - 19
IP  - 5
DP  - 2009 Oct
TI  - Lich-Gregoir ureteral reimplantation with fixation of ureter during detrusorraphy 
      as a reliable outpatient anti-reflux procedure.
PG  - 320-4
LID - 10.1055/s-0029-1233496 [doi]
AB  - PURPOSE: We report our experience with a Lich-Gregoir reimplantation (LGR) 
      technique that included fixation of the ureter during detrusorraphy to preserve 
      the integrity of the newly created submucosal tunnel, performed as an outpatient 
      anti-reflux procedure. METHODS: Ninety-seven children (mean age: 7.9 years) with 
      primary VUR underwent LGR between 1995 and 2008. Twenty-one had bilateral VUR, 8 
      had ureteral duplication, 9 had megaureter, and 13 had previous subureteric 
      injections. Through a Pfannenstiel incision the ipsilateral ureter was mobilized 
      up to the ureterovesical junction without disturbing ureterotrigonal integrity. A 
      3-5 cm detrusorotomy was extended from the ureterovesical junction towards the 
      umbilicus, the ureter was placed on the mucosa, and detrusorraphy was performed 
      with a loosely running 3/4-0 polyglactin suture that passed through the detrusor 
      on one side of the incision, taking a 1-2 mm "bite" of the ureteral adventitia, 
      and detrusor on the other side. Postoperative ultrasonograms and voiding 
      cystograms (VCUG) were obtained at 1 and 3 months, respectively. Children were 
      then followed up for clinical symptoms of urinary tract infection with annual 
      ultrasonograms. RESULTS: The mean operative time was 56 min. Eighty-one percent 
      of the children were treated as outpatients. Transient voiding difficulties 
      occurred in 2 children with a bilateral procedure. Reflux was cured in 116 
      ureters (98%) with a mean follow-up of 58 months (range: 6-128). Ipsilateral 
      obstruction was not evident during ultrasound surveillance. CONCLUSIONS: LGR is 
      an outpatient procedure with a high success rate and a low morbidity. Integrity 
      of the newly created submucosal tunnel is important for long-term success, which 
      may be facilitated by our modified detrusorraphy technique.
CI  - (c) Georg Thieme Verlag KG Stuttgart - New York.
FAU - Onol, F F
AU  - Onol FF
AD  - Sakarya Training and Research Hospital, Urology, Sakarya, Turkey. 
      ffonol@yahoo.com
FAU - Akbas, A
AU  - Akbas A
FAU - Erdem, M R
AU  - Erdem MR
FAU - Onol, S Y
AU  - Onol SY
LA  - eng
PT  - Journal Article
DEP - 20090910
PL  - United States
TA  - Eur J Pediatr Surg
JT  - European journal of pediatric surgery : official journal of Austrian Association 
      of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
JID - 9105263
SB  - IM
MH  - Adolescent
MH  - *Ambulatory Surgical Procedures
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Minimally Invasive Surgical Procedures
MH  - *Replantation
MH  - Ureter/*surgery
MH  - Urologic Surgical Procedures/*methods
MH  - Vesico-Ureteral Reflux/*surgery
EDAT- 2009/09/12 06:00
MHDA- 2010/01/20 06:00
CRDT- 2009/09/12 06:00
PHST- 2009/09/12 06:00 [entrez]
PHST- 2009/09/12 06:00 [pubmed]
PHST- 2010/01/20 06:00 [medline]
AID - 10.1055/s-0029-1233496 [doi]
PST - ppublish
SO  - Eur J Pediatr Surg. 2009 Oct;19(5):320-4. doi: 10.1055/s-0029-1233496. Epub 2009 
      Sep 10.