Razvoj kirurškog liječenja vezikoureteralnog refluksa u djece u Hrvatskoj

Aim: To review the development of surgical and endoscopic treatment of vesicoureteral reflux (VUR) in children in Croatia using data available in published studies and other verifiable historical sources, and to relate the historical experience of Croatian centres to contemporary individualized indications for intervention. Methods: A narrative review was conducted using PubMed, the Croatian Hrčak database, institutional repositories, monographs, and official institutional histories. The search covered the period from the earliest historical reports to 25 August 2026 and combined terms related to VUR, children, ureteral reimplantation, endoscopic and robotic treatment, and Croatian centres. Results: The first independent Department of Paediatric Surgery in Croatia was founded at Klaićeva in 1951, and a paediatric surgical department was established at Rebro soon afterwards; surgical treatment of VUR at Rebro has been documented since 1958. In Rijeka, the Department of Paediatric Surgery was founded in 1965, while organized paediatric surgery in Split began in 1971 with the establishment of a dedicated section. The Bradić–Pasini antireflux ureterocystostomy was introduced in the early 1970s and published in 1975. A 1988 series included 618 children and 824 reimplantations, with initial success in 792 ureteral units (96.1%). A combined Zagreb series from 1958 to 2012 comprised 3,734 procedures in 2,988 children. By the end of 2012, 632 children had been treated for VUR in Rijeka. In Varaždin, 323 Bradić–Pasini procedures were performed in 316 children between 1978 and 2005, with a success rate of 94.4%. Since the beginning of the 21st century, centres in Split, Rijeka, and Zagreb have reported substantial series of endoscopic treatment. The Split series published in 2025, covering the period 2017–2024, reported success rates of 80.6% for endoscopic treatment and 96.2% for open surgery. No peer-reviewed Croatian paediatric series of robot-assisted ureteral reimplantation for VUR was identified by the search cut-off date. Conclusion: Croatia followed the development of international antireflux surgery from an early stage and made an original contribution through the Bradić–Pasini technique. Contemporary surgical management is based on a personalized approach to each child rather than on the linear replacement of open surgery by endoscopic or robotic procedures. The choice of treatment should be individually tailored according to the risk of febrile urinary tract infections, renal parenchymal damage, the grade and anatomical characteristics of reflux, bladder and bowel function, and the response to conservative treatment. Standardized registries and uniform outcome definitions are needed for future national comparisons.