小儿尿道下裂尿道成型术后尿瘘的治疗

目的总结提高尿道下裂尿道成型术后尿瘘修复成功率的经验。方法尿道下裂成型术后尿瘘患儿68例。其中尿瘘口直径〈3 mm者58例,采用Y-V修补法,修剪瘘口皮肤,皮下组织连续缝合;3~10 mm者7例,采用Thiersch法翻转皮瓣修复瘘口;〉10 mm者3例,采用Dennis-Browne法修复较大的尿道缺损。手术时保证皮瓣的创面和创面缝合。结果手术一次成功率为91.2%。结论正确选择手术方法、必要时利用显微镜辅助、提高缝合技巧、选用可吸收缝线等可提高修补成功率。

Management of urethral fistula after hypospadias repair

Objective To summarize the clinical experience in urethral fistula repair after hypospadias urethroplasty.Methods Sixty-eight cases of urethral fistula after hypospadias repair were reviewed.Fifty-eight small ones with diameter <0.3 mm,were closed by 3-layer closure technique and Y-V skin flap technique;7 cases of medium size with diameter 3-10 mm,were repaired using a procedure similar to Thiersch urethroplasty;3 fistulae with diameter >10 mm,were repaired by Dennis-Browne urethroplasty.Results The success rate after one attempt was 91.2%.Conclusion Right selection of the operative procedure,utilization of an operation microscope,skillful suture using synthetic absorbable material,all will contribute to the success of the surgery.