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目的:探讨包皮重建在尿道板纵切卷管术(tubularized incised plate, TIP)治疗远端型尿道下裂中的临床应用价值。方法:回顾性分析2017年11月至2018年4月收治的应用TIP术式治疗的64例远端型尿道下裂患儿的临床资料。其中28例行包皮重建(包皮重建组)，36例行包皮环切(包皮环切组)。比较两组手术时间、术后并发症发生率及再手术率的差异。结果:包皮重建组手术时间为(109.9±2.2)min，较包皮环切组(143.8±3.0)min明显缩短，组间比较，差异有统计学意义(n P<0.000 1)。包皮重建组术后发生尿道并发症2例(7.1%)，包括尿瘘1例和尿道外口狭窄1例；包皮环切组术后发生尿道并发症4例(11.1%)，包括尿瘘1例、阴茎头裂开2例和尿道外口狭窄1例，两组尿道并发症发生率比较，差异无统计学意义(n P＝0.688)。包皮重建组术后出现重建包皮裂开2例(7.1%)，包皮环切组术后有1例(2.8%)出现阴茎向一侧扭转约30°，两组皮肤并发症发生率比较，差异无统计学意义(n P＝0.577)。包皮重建组再手术3例(10.7%)，包括尿瘘修补1例和包皮环切2例；包皮环切组再手术3例(8.3%)，包括尿瘘修补1例和远端尿道及阴茎头成形2例，两组再手术率比较，差异无统计学意义(n P＝0.746)。n 结论:TIP治疗远端型尿道下裂时行包皮重建手术简单易行，与包皮环切组相比没有增加术后并发症的发生率及再手术率，且因保留了包皮，可以更好的隐匿阴茎畸形，同时为术后发生并发症再次手术提供了有利条件。因此在行TIP修复远端型尿道下裂时，可根据包皮条件及患儿家长的意愿选择进行包皮重建手术。“,”Objective:To evaluate the efficacy of foreskin reconstruction for distal hypospadias during tubularized incised plate (TIP) repairing.Methods:From November 2017 to April 2018, 64 children with distal hypospadias underwent stented TIP urethroplasty. Foreskin reconstruction (n n=28) and circumcision (n n=36) were performed and compared with regards to operative duration and postoperative complications.n Results:The operative duration was [(109.9±2.2) vs. (143.8±3.0)] min in foreskin reconstruction and circumcision groups respectively (n P<0.0001). Urethroplasty complications occurred in 4(11.1%) circumcision children (fistula,n n=1; glans dehiscences, n n=2; meatal stenosis, n n=1) versus 2(7.1%) after prepucioplasty (fistula, n n=1; meatal stenosis, n n=1) (n P=0.688). Skin complications included preputial dehiscences (n n=2, 7.1%) in foreskin reconstruction group and penile torsion (n n=1, 2.8%) in circumcision group (n P=0.577). The reoperative rate was 10.7% (3/28) in foreskin reconstruction group including fistula repair (n n=1) and circumcision (n n=2) for foreskin dehiscence versus 8.3% (3/36) in circumcision group including fistula repair (n n=1) and glansplasty (n n=2) (n P=0.746). No significant inter-group differences existed in urethroplasty and skin complications or reoperative rate.n Conclusions:During TIP repairing, foreskin reconstruction is a time-saving procedure with similar complication and reoperative rate to traditional technique. Prepuce preservation may hide most penile malformations and provide valuable local tissues for dealing with potential complications. Foreskin reconstruction is a surgical alternative for distal hypospadias using TIP repair based upon prepuce appearance and parental preference.