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目的探讨重症尿道下裂成形术的新方法、新术式。方法利用显微外科行带蒂阴囊L形皮瓣一期尿道成形。术中注意皮瓣长度、宽度、厚度及皮下血管吻合支。横部皮瓣血管供应,因靠皮下取材不宜太长。结果经52例L型阴囊皮瓣成形尿道,术后尿瘘1例(1．9%),尿道狭窄2例(3．8%),手术成功率94．09%。结论显微外科带血管蒂L型皮瓣成形尿道,有效解决了重症尿道下裂皮瓣不足问题,防止皮瓣血管损伤,操作方便,是重症尿道下裂最佳术式。
Objective To explore a new method and new operation for severe hypospadias operation. Methods Microsurgery was performed on stage I urethroplasty with pedicle scrotum L-shaped flap. Intraoperative attention to flap length, width, thickness and subcutaneous vascular anastomosis. Transverse flap vascular supply, due to subcutaneous drawing should not be too long. Results The urethra was formed by 52 L - shaped scrotum flaps. The postoperative urinary fistula was 1 case (1.9%) and urethral stricture was 2 cases (3.8%). The successful rate was 94.09%. Conclusion Microsurgery vascular pedicle L-shaped flap forming urethra, an effective solution to the problem of severe hypospadiosis flap to prevent skin flap injury, easy to operate, is the best surgery for severe hypospadias.