摘要
目的 探讨改良的尿道板重建卷管尿道成形术（Koyanagi）结合睾丸鞘膜覆盖,在重度尿道下裂矫治中的应用.方法 选取49例重度尿道下裂患儿,随机分为2组,25例采用改良Koyanagi术结合睾丸鞘膜覆盖治疗,24例行Duplay＋ Duckett尿道成形术,比较2组的手术效果及术后并发症的发生情况.结果 25例行改良的Koyanagi术患儿中,20例治愈;3例发生尿瘘,6个月后经尿瘘修补术治愈;2例尿道狭窄,经1～3个月尿道扩张后可正常排尿.24例行Duplay＋ Duckett尿道成形术的患儿,治愈17例;尿瘘4例,6个月后经尿瘘修补术治愈;尿道狭窄3例,经1～3个月尿道扩张后可正常排尿.2种手术方法的成功率比较,差异无统计学意义（P ＞0 05）.结论 改良的Koyanagi术治疗重度尿道下裂,手术方法相对简单,结合睾丸鞘膜覆盖可进一步降低并发症的发生率。
Objective To investigate the clinical effect of modified Koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias.Methods 49 cases with severe hypospadias treated from Jan.2009 to Sep.2011 were retrospectively studied.25 patients underwent Koyanagi technique with coverage by tunica vaginalis of testis.24 cases underwent one-stage Duplay ＋ Duckett technique in the same term.The patients were followed up for 7-24 months.Results Among the 25 children treated with Koyanagi procedure,20 cases were cured,5 patients had postoperative complications,including urethral fistula in 3 cases,urethral stenosis in 2 cases.At the same time,in the Duplay ＋ Duckett group,17 cases were cured,7 children had postoperative complications,including urethral fistula in 4 cases,and urethral stenosis in 3 cases.All the patients with urethral fistula were repaired successfully 6 months after the first surgery; The urethral stenosis were cured by dilatation within 1 to 3 months.The successful rate in the 2 groups had no significant difference（P ＞ 0 05）.Conclusions Koyanagi technique with coverage by tunica vaginalis of testis is relatively simple with similar effect as Duplay ＋ Duckett technique for severe hypospadias.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2014年第6期436-438,共3页
Chinese Journal of Plastic Surgery
