论文部分内容阅读
目的探讨应用阴茎背侧横形岛状带蒂皮瓣(Duckett术)Ⅰ期修复尿道下裂的疗效。方法尿道下裂患儿64例,其中阴茎体型52例,冠状沟型12例。应用显微外科技术,裁取阴茎背侧横行岛状带蒂皮瓣制成皮管,绕阴茎转至腹侧,与原尿道远端吻合Ⅰ期尿道成形。结果所有患者均Ⅰ期修复成功。术后并发尿瘘7例,其中2个瘘口2例,单一瘘口5例,6～12个月后行瘘口修补后痊愈;尿道外口狭窄3例,经尿道扩张1～2个月后缓解,无其他并发症。48例随访1～3年,阴茎外观较好,排尿正常。结论应用Duckett术式Ⅰ期修复尿道下裂,皮瓣血供丰富,成功率高,术后阴茎外观较好,但尿瘘的发生率较高,有待进一步改良。术中应用显微外科技术,可减少皮瓣血供损伤,提高缝合质量,减少并发症的发生。
Objective To evaluate the clinical efficacy of Duckett’s surgery on the repair of hypospadias with stage Ⅰ penis dorsal cross-shaped island pedicle flap. Methods 64 cases of children with hypospadias, including 52 cases of penis size, coronal type in 12 cases. Application of microsurgical techniques, the dorsal raphe lateral island pedicle flap flap made of leather, around the penis to the ventral, with the distal urethral anastomosis stage urethra. Results All patients were successfully repaired in stage Ⅰ. There were 7 cases of urinary fistula after operation, including 2 cases of 2 cases of fistula, 5 cases of single fistula, 6 cases of fistula repair after 6 to 12 months, 3 cases of urethral stenosis, 1 to 2 months after urethral dilatation Relieved, no other complications. 48 cases were followed up 1 to 3 years, the penis appearance is good, normal urination. Conclusions Duckett’s surgical procedure can repair hypospadias. The flap is rich in blood supply and has a high success rate. The postoperative appearance of the penis is good, but the incidence of urinary fistula is high and needs to be further improved. Intraoperative application of microsurgical techniques can reduce blood supply injury flap, improve suture quality, reduce the incidence of complications.