摘要
目的 总结尿道板斜切延长纵切卷管尿道成形术治疗尿道下裂的经验。方法 回顾性分析2015年6月至2015年11月收治的21例行尿道板斜切延长纵切卷管尿道成形术的尿道下裂患儿的临床资料。本组年龄1岁6个月～4岁11个月，平均2.8岁。阴茎体型17例，阴茎阴囊型4例。所有病例均为首次手术病例。手术方法：保留尿道板，将阴茎皮肤脱套至阴茎根部，充分伸直阴茎。于尿道板正中纵切增宽尿道板，于阴茎弯曲最明显处斜切延长尿道板，留置导尿管，卷管成形尿道。结果 本组手术时间65～100 min，平均78 min。术后近期发生尿道瘘3例（14.3%），尿道狭窄4例（19.0%），均在1～3次尿道扩张后缓解。术后3个月发生尿道瘘2例，无尿道狭窄、尿道憩室患儿，3个月并发症发生率为9.5%。阴茎伸直效果满意。结论 尿道板斜切延长纵切卷管尿道成形术治疗尿道下裂近期效果满意，术后并发症发生率较低，且容易在基层医院开展。
Objective To summarize the experience of hypospadias repair with tubularized incision and prolonged plate urethroplasty.Methods From June 2015 to November 2015, a retrospective review of tubularized incision and prolonged plate urethroplasty was performed for 21 primary hypospadias patients. The clinical types were penile （n=17） and penoscrotal （n=4）. After reserving urethral plate and degloving penile skin to penile root, full straightening out was performed. Incision of middle urethral plate was intended for broadening urethral plate. And sideway incision in the most obvious bent place of penis was made to prolong urethral plate. After indwelling catheter, urethra was formed.Results The average operative duration was 78（65-100） min. Postoperative complications included urethral fistula （n=3, 14.3%） and urethral stricture （n=4, 19.0%）. All of them stayed in remission after 1-3 sessions of urethra dilatation. During a follow-up period of 3 months, 2 cases （9.5%） were complicated by urethral fistula. There was no instance of urethral stricture or recurrent penile curvature.Conclusions Tubularized incision and prolonged plate urethroplasty are effective for hypospadias. With a low incidence of postoperative complications, this procedure may be easily popularized at grass-roots.
出处
《中华小儿外科杂志》
CSCD
2017年第12期888-891,906,共5页
Chinese Journal of Pediatric Surgery
