Cohen versus Lich-Gregoir ureteral reimplantation for pediatric primary vesicoureteral reflux: a systematic review and meta-analysis of comparative studies.
Cohen and Lich-Gregoir reimplantation showed no significant difference in persistent reflux in children with primary vesicoureteral reflux.
Cohen versus Lich-Gregoir ureteral reimplantation for pediatric primary vesicoureteral reflux: a systematic review and meta-analysis of comparative studies.
Cohen and Lich-Gregoir ureteral reimplantation are the two most widely used open reconstructive options for children with primary vesicoureteral reflux (vesicoureteral reflux), yet their relative advantages remain debated.
We aimed to compare anti-reflux efficacy, perioperative outcomes, and complication profiles between these procedures using direct comparative evidence only.
Because fewer than 10 studies contributed to each synthesis, formal publication-bias testing was not performed.
odds of persistent reflux after Cohen versus Lich-Gregoir, no clear difference either way
Baseline age and preoperative reflux grade were comparable between groups.
Lich-Gregoir was associated with shorter operative time [mean difference (MD) 28.59 minutes, 95% CI: 3.37-53.81] and shorter LOS (MD 3.41 days, 95% CI: 2.15-4.61).
In bilateral vesicoureteral reflux, Lich-Gregoir retained advantages in operative time and LOS, but differences in overall complications, persistent reflux, and acute retention of urine were not statistically significant.
Cohen and Lich-Gregoir reimplantation provide comparable anti-reflux efficacy and similar major postoperative outcomes in children with primary vesicoureteral reflux.
Lich‑Gregoir was associated with shorter operative time with very high heterogeneity, but procedure selection should also consider its higher risk of postoperative urinary retention and the still-limited evidence in bilateral disease.