论文部分内容阅读
目的:探讨横裁包皮带蒂岛状皮瓣尿道成形术(Duckett术)一期治疗尿道下裂的临床效果。方法:回顾性研究我科2003年～2007年采用Duckett术式一期修复尿道下裂患者20例,年龄2～22岁,平均11.3岁,其中阴茎体型3例,阴茎阴囊型17例;另外收集同期行膀胱粘膜代尿道术尿道下裂30例,年龄7～34岁,平均16.1岁,其中阴茎体型10例,阴茎阴囊型16例,会阴型2例,阴囊型2例。膀胱粘膜术全部行膀胱造瘘及留置尿道支架管,Duckett术仅留置尿道支架管。结果:Duckett术:1次手术成功17例(85%),术后尿瘘2例(10%),尿道狭窄1例(5%),2例尿瘘术后6个月修补成功,人均手术次数为1.1次;膀胱粘膜代尿道术:手术均分二期完成,手术成功26例(86.7%),术后尿瘘3例(10%),尿道狭窄1例(3.3%),再次手术修补瘘口治愈,人均手术次数为2.1次。2例尿道狭窄行尿道扩张后基本痊愈。结论:Duckett术一期修复尿道下裂效果良好,手术成功率与其他术式相近、术后并发症低,与膀胱粘膜尿道成形术相比,术后阴茎外观更满意,主要优点是一次完成手术。
Objective: To investigate the clinical effect of transcortical island flap pedicled urethroplasty (Duckett’s surgery) in the treatment of hypospadias. Methods: A retrospective study of our department from 2003 to 2007 with Duckett surgical repair of hypospadias in patients with 20 cases, aged 2 to 22 years, mean 11.3 years, of which 3 cases of penis size, 19 cases of penis scrotum; the other collection In the same period, 30 cases of hypospadias were treated with bladder mucosa instead of urethra. The age ranged from 7 to 34 years (average 16.1 years). There were 10 cases of penis size, 16 cases of penis scrotum, 2 cases of perineal and 2 cases of scrotum. Bladder mucosal surgery all bladder cystostomy and indwelling urethral stent tube, Duckett only retained urethral stent tube. RESULTS: Duckett’s surgery was successful in 17 cases (85%) in one operation, in 2 cases (10%) in urinary fistula and in 1 case (5%) in urethral stricture. The urinary fistula was repaired 6 months after operation, 1.1 times; urinary bladder mucosa surgery: surgery was completed in two phases, the successful operation of 26 cases (86.7%), postoperative urinary fistula in 3 cases (10%), urethral stricture in 1 case (3.3%), reoperation to repair fistula , Per capita number of operations for 2.1 times. Two cases of urethral stricture urethral dilatation basically recovered. Conclusions: The first stage of Duckett’s surgery to repair hypospadias has a good effect. The success rate of surgery is similar to that of other procedures. The postoperative complications are low. Compared with bladder mucosa and urethroplasty, postoperative penile appearance is more satisfactory. The main advantage is that one operation .