Our experience in the treatment of the vesico-ureteral reflux with Lich-Gregoir antireflux surgical procedure

In the period between January 1980 and December 1990 we had applied the ope rative Lich-Gregoir antireflux method on 166 patients, all of whom were chi ldren and adolescents, and performed 275 antireflux surgical procedures. Th e application of the above mentioned method on our patients yielded a succe ss of 97.8 %. There have been no intraoperative complications which would a ffect 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 conside ring it to be a further improvement in achieving better results. We fixed t he ureter to the detrusor with additional stitches in the newly formed hiat us, i.e. at the exit of the ureter out of the new submucous canal. The poss ibility of arousing postoperative paraostial diverticula is thus avoided, e nabling us, at the same time, to enhance the newly formed ureteral hiatus i n the detrusor. In this way the possibility of postoperative ureter stenose s is reduced. According to our experience the above mentioned antireflux method does not give good postoperative results in patients with greatly dilated and aperis taltic ureter (megacystis-megaureter type), while all other examples show a high percentage of postoperative success.