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19–22 APRIL, 2017, BARCELONA, SPAIN
09:17–09:20
S5-5 (PP)
PEDIATRIC VESICOURETERAL REFLUX: A COMPARATIVE
STUDY AMONG STING PROCEDURE, LAPAROSCOPIC
LICH-GREGOIR PROCEDURE AND COHEN TECHNIQUE
USING OPEN SURGERY
Francesco TURRA’
1
, Ciro ESPOSITO
2
, Maria ESCOLINO
3
, Manuel LOPEZ
4
,
Antonio SAVANELLI
2
, Alessandra FARINA
2
, Alessandro SETTIMI
2
and Francois VARLET
4
1) Federico II University of Naples, Pediatric Surgery, Naples, ITALY - 2) Federico II University of Naples, Traslational
Medical Sciences, Naples, ITALY - 3) Federico II Unoversity of Naples, Traslational Medical Sciences, Naples, ITALY -
4) Centre Hospitalier Universitaire, Hopital Nord, Saint-Etienne, France, Pediatric Urology, Saint-Etienne, FRANCE
PURPOSE
This retrospective trial compared the results and drawbacks of 3 surgical procedures currently
adopted for treatment of VUR: intravesical open Cohen, laparoscopic extravesical ureteral reim-
plantation according to Lich Gregoir (LEVUR) and endoscopic (STING) procedure.
MATERIAL AND METHODS
We analyzed 90 consecutive patients (mean age 4.86 years) operated in 2 pediatric surgical centers
for VUR. Exclusion criteria were I or V degree VUR, associated with megaureter requiring ureteral
tapering or patients already operated for VUR. Thirty patients underwent Cohen, 30 underwent
LEVUR and 30 underwent STING procedure. The groups were compared in regard to operative
time, hospitalization, postoperative pain, analgesic requirements, reflux persistence and complica-
tions. Statistical analysis was carried out using χ2 test and t-student test.
RESULTS
Operative time was shorter using STING compared to the other techniques (28.17 min [STING] vs
125,50 min [LEVUR] vs 135,68 min [Cohen]; p < 0.001). Hospitalization was statistically shorter
using STING and LEVUR compared to Cohen (3.10 vs 12.71 days ; p < 0.003). The VAS pain score
were worse after Cohen (p < 0.001). Hematuria occurred only after Cohen (p < 0.001). Analgesic
requirements were higher after Cohen compared to STING and LEVUR (4.91 vs 1.21 days ; p <
0.001). Reflux persistence was higher after STING (13 cases vs 11 Cohen and 4 LEVUR). Cohen
presented more complications compared to LEVUR and STING (p=0.021).
CONCLUSIONS
Comparing the 3 techniques it seems that LEVUR presents a high success rate as Cohen proce-
dure, but also all the advantages of STING with a short and painless post-operative period, without
hematuria.