横裁岛状包皮皮瓣一期修复尿道下裂的经验

目的总结横裁岛状包皮皮瓣法修复先天性尿道下裂的经验。方法对1999年-2005年我科56例采用横裁岛状包皮皮瓣法进行尿道成形的尿道下裂患儿进行回顾性分析。其中5例加用尿道口为基底的阴囊矩形皮瓣作Duplay尿道成形。结果本组病例均获随访，时间3个月-4年，阴茎外观良好，阴茎下弯矫正满意，排尿通畅。一次手术成功49例，占89．3％；术后尿瘘5例，经第二次手术修补后痊愈，尿道狭窄1例，经尿道扩张后排尿改善。结论横裁岛状包皮皮瓣符合阴茎皮肤的解剖生理特点，设计合理，采用吻合口连续缝合，更加降低了尿瘘的发生率，避免耻骨上造瘘及带来的膀胱损伤。对多数尿道下裂尤其是有阴茎下弯的尿道下裂，采用横裁包皮岛状皮瓣法并灵活加用尿道口基底矩形皮瓣是一个很好的选择。

Experience of Hypospadias Stage I Repair Using Tranverse Cutting Islandform Prepuce Skin Flap

Objective To summarize the experience of tranverse cutting the islandform prepuce skin flap technique applied to the hypospadias. Methods 56 children with hypospadias treated using urethroplasty with cross cutting islandform prepuce skin flap technique were reviewed.5 cases of them except that the operation was carried out,,they have a duplay throplasty by using scrotum rectangular skin flap with urethra orifice base operation. Results All the cases were follwed up for 3 months to 4 years, the appearance of peris of the children was normal, chordee of scrotum was satisfactory corrected,emiction unobstructed,once the operation success rate reached 89.3%(49cases),but 5 cases occurred urethral fistula complication,after the second the operation,these sick children well recovery,their urethral stricture improvement by urethra dilation method,and normosthenuria. Conclusions:The operation procedure is conform to anatomy-physiologica feature, projection reasonableness,tranverse anastomotic continuious suture can obviously decrease urethral fistula morbidity, avoidables urinary bladder injury caused from the operation, at the same time can avoid fistulation, or the therpulis.For the most the cases,specially hypospadias with chordee of scrotum,using cross cutting lslandform prepuce srin flap technique and quick pulse rectangular skin flap grafting on urethra orifice base is a better choice for the disease.