尿道下裂成形术后尿瘘的修补(附56例报告)

目的 通过改进手术方法、缝合材料、尿道支架等方式,提高尿道下裂成形术后尿瘘1次修补的成功率。方法 分析、总结56例尿道下裂成形术后尿瘘患者的临床资料,其中大瘘口(瘘口直径大于3mm)38例,小瘘口(瘘口直径小于3mm)18例。大瘘口采用双皮片法或带蒂阴囊皮瓣修补,小瘘口采用横Y-V皮瓣修补。支架管采用多孔硅胶“管中管”。结果 1次修补成功率达87.50%,其中大瘘的修补成功率达86.84%。结论 保证修补皮瓣的血运、合成可吸收线的使用及尿道支架的引流等可提高修补成功率。

Repair of urethral fistula resulting from correction of hypospadias:experience with 56 cases

Objective To improve the success rate of on e- stage urethral fistula repair by modifying the surgical procedures, suture mate rial and application of urethral stent. Methods The clinical data of 56 cases of urethral fistula following correction of hypospadias were analyzed. The case g roup consisted of 38 cases with large fistula (over 3 mm in diameter) and 18 cas es of small fistula (less than 3 mm). For the former cases, double skin flaps o r pedicled skin flap from the scrotum were adopted for the repair; in the latte r cases, transverse Y- or V-shaped skin flaps were used. Porous silica gel cann ula was adopted for the stents. Result A success rate of one-stage repair as hi gh as 87.50% was achieved in these cases, with a rate for large fistula of 86.84 %. Conclusion Rich blood supply of the flaps, application of absorbable suture a nd urethral stent can improve the suc-cess rate of fistula repair.