Zingg E J, Bandelier D
Helv Chir Acta. 1981 Aug;48(3-4):315-21.
From 1970 to 1980 forty-four ureters with vesico-ureteral-renal (VUR) reflux were treated surgically at the University Urologic Clinic, Inselspital, Berne. According to Hodson's classification, four patients were grade 1, 23 grade 2 and 17 grade 3. Distribution of the renal lesions by Smellie's classification was 4 without renal lesion, 24 with grades 1 and 2, and 16 in grade 3 and 4. Comparison of the results of these two classifications shows that the higher the degree of reflux, the more severe the renal lesions. In over 70% of cases the ostia were malpositioned and stadium, horseshoe or golf hole-shaped. Our surgical indication is based on the type of reflux, the renal lesions, localization of the ostia, peaking fever linked to clinical finding of pain in the seat of the kidney and micturitional disorders. Uretero-cysto-neostomy by the Politano-Leadbetter technic was performed 35 times, by that of Paquin 5 times, by that of Cohen twice and by that of Lich-Grégoire twice. Despite 90% surgical success, we have observed that chronic pyelonephritis continues to exist and that the improvement produced by surgery is chiefly a clinical one, in the form of elimination of the fever pain episodes.
1970年至1980年间，伯尔尼因塞尔医院大学泌尿外科诊所对44例伴有膀胱输尿管反流（VUR）的输尿管进行了手术治疗。根据霍德森分类法，4例为1级，23例为2级，17例为3级。按照斯梅利分类法，肾损害分布情况为：4例无肾损害，24例为1级和2级，16例为3级和4级。这两种分类结果的比较显示，反流程度越高，肾损害越严重。超过70%的病例中，输尿管口位置异常，呈体育场形、马蹄形或高尔夫球洞形。我们的手术指征基于反流类型、肾损害情况、输尿管口位置、与肾区疼痛及排尿障碍临床表现相关的高热情况。采用波利塔诺 - 利德贝特技术进行输尿管膀胱新造口术35次，采用帕昆技术5次，采用科恩技术2次，采用利希 - 格雷瓜尔技术2次。尽管手术成功率达90%，但我们观察到慢性肾盂肾炎仍持续存在，且手术带来的改善主要是临床方面的，表现为发热疼痛发作的消除。
