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目的 探讨序贯悬吊法在腹腔镜Lich-Gregoir手术治疗儿童原发性膀胱输尿管反流(primary vesicoureteral reflux,VUR)中的安全性和有效性.方法 回顾性分析电子科技大学医学院附属妇女儿童医院2017年4月至2018年4月采用序贯悬吊法辅助完成腹腔镜Lich-Gregoir手术治疗儿童原发性膀胱输尿管反流的14例患儿临床资料.14例患儿均因反复尿路感染入院,男5例,女9例;平均年龄36个月,范围9～72个月;右侧8例,左侧6例.术前Ⅲ级反流3例,Ⅳ级或Ⅴ级反流11例,肾图提示存在肾瘢痕.结果 14例患儿均在腹腔镜下顺利完成手术,无中转开腹者.平均手术时间为45 min,范围40～63min;术中平均出血量3.5 ml,范围2～8 ml.术后3个月复查排泄性尿路造影检查,仅1例为Ⅰ级反流,余均未见反流,术后6个月泌尿系超声造影检查、术后9个月排泄性膀胱尿道造影(voiding cystourethrography,VCUG)检查均未见有反流.术后6个月复查肾图未发现新的肾瘢痕出现.14例患儿随访至今无尿路感染发生.结论 腹腔镜Lich-Gregoir手术操作中采用腹壁序贯悬吊法,能安全有效的暴露术野,并缩短切开膀胱浆肌层和包埋输尿管的操作时间.“,”Objective To explore the safety and efficacy of abdominal sequential suspension in laparoscopic Lich-Gregoir procedure in children with primary vesicoureteral reflux (VUR).Methods From April 2017 to April 2018,clinical data were retrospectively analyzed for 14 children with primary VUR undergoing laparoscopic extravesical reimplantation (Lich-Gregoir technique).Results All children were hospitalized for recurrent urinary tract infection.There were 5 boys and 11 girls with a mean age of 36(9-72) months.The involved side was left (n =6) and right (n =8).Grades Ⅲ (n =3) and Ⅳ/Ⅴ (n =11) of VUR were confirmed by voiding cystourethrography (VCUG).Renal scars were assessed by dimercaptosuccinic acid (DMSA) scan.All laparoscopic Lich-Gregoir operations were successful.The average operative duration was 45(40-62) min and the mean intraoperative blood loss 3.5(2-8) ml.The disappearance of VUR was confirmed by VCUG in all children at 3 months postoperatively,except one with grade Ⅰ.No reflux occurred on contrast-enhanced ultrasonography at 6 months postoperatively and VCUG at 9 months postoperatively.There was no recent renal scarring or urinary tract infections since then.Conclusions During laparoscopic Lich-Gregoir operation,abdominal sequential suspension can effectively expose surgical field and shorten the operative duration of cutting bladder muscle laver and embedding ureter.