ÖZET Çalışmamızda vezikoüreteral reflü (VUR) nedeniyle endoskopik subüreterik enjeksiyon (STING) ve/veya Cohen ile Lich Gregoiry tekniği ile üreteroneosistostomi (UNC) yapılan hastalar değerlendirilerek iki tedavi yönteminin etkinliğinin saptanması amaçlandı. Materyal ve Metod: Eylül 2010 ve Eylül 2020 tarihleri arasında VUR sebebiyle STİNG ve/veya UNC yapılan yaşları 1 ile 18 arasında değişen (Ortalama: 7.71±4.5) 85 hasta (144 renal ünite) çalışmaya dahil edildi. Hastalar klinik, laboratuvar, görüntüleme bulguları, ameliyat verileri açısından değerlendirildi. Açık cerrahi olarak Cohen ve Lich Gregoiry tekniği ile UNC yapılırken endoskopik olarak dekstranomer / hyaluronik asit kullanılarak STING yapıldı. Tedavide başarı kriteri olarak post-operatif bakılan voiding sistoüretrogramda VUR görülmemesi veya evre I'e düşmesi kabul edildi. Bulgular: Hastaların 55 tanesi kız (%64), 30 tanesi erkek (%36) idi. Hastaların 26'sında (%31) izole sol, 18'inde (%21) izole sağ, 41'inde (%48) bilateral VUR mevcuttu. Hastalarda en sık başvuru şikayeti üriner sistem enfeksiyonu (ÜSE) (%60) iken idrar kültürlerinde en sık üreyen mikroorganizma escherichia coliydi. 59 renal ünitede (%41) pelvikalisiyel ektazi tespit edildi. 81 renal ünitede (%56,2) renal parankimal skar mevcuttu. Toplamda 68 (%47.2) renal üniteye UNC yapılırken 76 renal üniteye (%52.8) STING yapıldı. STING yapılan renal ünitelerde en sık grade III VUR izlenirken UNC yapılan renal ünitelerde en sık grade V VUR izlendi. STING yapılan 76 renal ünitenin 35'inde reflü izlenmezken, 10'unda reflü grade I'e geriledi. 14 renal ünitede reflü derecesi azaldı ancak başarılı olunamadı. UNC yapılan 68 renal ünitenin 65'inde reflü izlenmezken 3'ünde başarılı olunamadı. Hastanede kalış süresi UNC yapılan hastalarda 6,2 (±1,6) gün iken, STING yapılan hastalar aynı gün taburcu edildi. Post-operatif UNC yapılan 2 hastada (%4.7) ÜSE, 2 hastada (%4.7) hematüri, 1 hastada (%2.3) hidronefroz görüldü. STING yapılan 1 hastada (%2.1) ÜSE görüldü. Sonuç: VUR'un cerrahi tedavisinde Cohen ve Lich Gregoiry UNC düşük morbidite ve yüksek başarı oranlarıyla etkin bir tedavidir. STING düşük komplikasyon oranı, kısa hastanede yatış süresi, kısa operasyon süresi ile özellikle düşük dereceli reflülerde etkin bir tedavidir. STING başarı oranı UNC kadar yüksek değildir

ABSTRACT In our study, it was aimed to determine the effectiveness of the two treatment methods by evaluating the patients who treated with endoscopic subureteric injection (STING) and/or ureteroneocystostomy (UNC) with the Cohen and Lich- Gregoir techniques due to vesicoureteral reflux (VUR). Materials and methods: Between September 2010 - September 2020, 85 patients (144 renal units), aged 1 to 18 years (mean: 7.71±4.5) who treated with STING and UNC because of VUR were included in the study. The patients were evaluated in terms of clinical, laboratory outcomes, imaging findings, and surgical data. While UNC was performed with the Cohen and Lich Gregoir techniques as open surgery, STING was performed endoscopically using dextranomer / hyaluronic acid. Absence of VUR in post-operative voiding cystourethrogram or its decrease to stage 1 was accepted as a success criterion in the treatment. Results: There were 55 (%64) female patients and 30 (%36) male patients. There were isolated left in 26 (%31) patients, isolated right in 18 (%21) patients and bilateral VUR in 41 (%48) patients. While the most common symptoms of patients is urinary tract infection (UTI) (%60), escherichia coli was the most common microorganism found in urine cultures. Pelvicalyceal ectasia was detected in 56 renal units (%40.3) . Renal parenchymal scarring was exist in 81 renal units (%56.2). While 68 (%47.2) renal units in total treated with UNC, 76 (%52.8) renal units treated with STING. In the renal units treated with the STING technique, Grade III was the most common grade. Grade V was the most common grade in renal units treated with UNC. Reflux was not observed in 35 of 76 renal units and regressed to grade I in 10 of 76 renal units that treated with STING teqnique. The degree of reflux decreased in 14 renal units, but it was not successful. Reflux was not observed in 65 of 68 renal units treated with UNC, but 3 of them were not successful. While the length of hospital stay of patients who treated with UNC was 6.2 (± 1.6) days, patients who treated with STING were discharged from the hospital on the same day. UTI were seen in 2 patients (%4.7), hematuria were seen in 2 patients (%4.7) and hydronephrosis were seen 1 patient (%2.3) who treated with postoperative UNC. UTI was seen in 1 patient (%2.1) who treated with STING. Conclusion: Cohen and Lich Gregoir UNC is an effective treatment with low morbidity and high success rates in the surgical treatment of VUR. STING is an effective treatment especially in low-grade reflux with its low complication rate, short hospital stay, and short operation time. STING success rate is not as high as UNC.