Our Experience in the Treatment of the Vesico-Ureteral Reflux with Lich-Gregoir Antireflux Surgical Procedure

Abstract In the period between January 1980 and December 1990 we had applied the operative Lich-Gregoir antireflux method on 166 patients, all of whom were children and adolescents, and performed 275 antireflux surgical procedures. The application of the above mentioned method on our patients yielded a success of 97.8 %. There have been no intraoperative complications which would affect the ultimate successful result of this antireflux operative method. However, early postoperative complications occurred in two of our patients, causing infection of the wound, which resulted in further ureter stenoses. Recurrent reflux occurred in 4 (2.2 %) and the stenoses also in other 4 (2.2%) operated ureters. The follow-up lasted from 4 up to 14 years. We added our personal detail to the original Lich-Gregoir antireflux method considering it to be a further improvement in achieving better results. We fixed the ureter to the detrusor with additional stitches in the newly formed hiatus, i.e. at the exit of the ureter out of the new submucous canal. The possibility of arousing postoperative paraostial diverticula is thus avoided, enabling us, at the same time, to enhance the newly formed ureteral hiatus in the detrusor. In this way the possibility of postoperative ureter stenoses is reduced. According to our experience the above mentioned antireflux method does not give good postoperative results in patients with greatly dilated and aperistaltic ureter (megacystismegaureter type), while all other examples show a high percentage of postoperative success.