摘要
目的总结Snodgrass手术及其改良手术在治疗小儿尿道下裂中的经验与体会.方法对120例采用Snodgrass手术及其改良手术行尿道成形的尿道下裂进行回顾分析.手术方法:施行Snodgrass手术时进行两方面的改进,即矫正阴茎下曲时行阴茎背侧折叠手术,同时游离近端尿道,以及仅在狭窄尿道板处正中纵向切开.结果105例在阴茎皮肤脱套后仍有轻-中度阴茎下曲;其中24例采用阴茎背侧中线阴茎折叠术矫正阴茎下曲,75例在行阴茎折叠术同时游离近端尿道使阴茎下曲得到完全矫正,6例游离近端尿道阴茎下曲得到完全纠正.34例尿道板正中全程切开,86例仅行尿道板远段正中切开.术后随访6～15个月,96例获得满意效果.尿瘘18例(发生率为15%),6例尿道外口狭窄且经尿扩得到明显改善.结论改良Snodgrass手术能Ⅰ期矫正冠状沟型、阴茎体型及部分阴茎阴囊型尿道下裂,对轻中度阴茎下曲通过尿道外口近端尿道游离和阴茎背侧白膜折叠能得到矫正.
Objective To review the efficacy of modified Snodgrass procedures in hypospadias repair. Methods Records of 120 patients who underwent modified Snodgrass operation were review. Results The 120 cases include 18 coronal, 85 midshaft, 12 penoscrotal and 5 scrotal hypospadias. Ventral penile curvature was detected by artificial erection in 105 boys and proximal urethral was mobilized by degloving. Patients were followed-up for 6～15 months. Fistula occurred in 18 patients （15%） and meatal stenosis in 6 （5 %）. No patient developed neourethral stricture or dehiscence. Conclusions Modified Snodgrass hypospadias repair creates a slitlike vertically oriented meatus and a functional neourethra. Furthermore the outcomes of modified Snodgrass technique are good in distal and proximal hypospadias, even in selected scrotal hypospadias.
出处
《中华小儿外科杂志》
CSCD
北大核心
2005年第10期511-513,共3页
Chinese Journal of Pediatric Surgery
