Snodgrass尿道成形术治疗冠状沟及阴茎体中间型尿道下裂

目的总结Snodgrass尿道成形术治疗冠状沟及阴茎体中间型尿道下裂的经验。方法回顾性分析2006--2010年采用Snodgrass尿道成形术治疗的483例冠状沟及阴茎体中间型尿道下裂患儿的临床资料，总结手术方法、术后并发症及处理。结果患儿手术年龄8个月至14岁，平均4岁8个月，手术时间45～100min，平均68min。术后并发症的总发生率为5．2％，其中术后尿道瘘3．5％，尿道口狭窄2．3％，伤口感染及裂开1．0％，阴茎扭转2．1％，尿道憩室0．4％。冠状沟型与阴茎体中间型尿道下裂术后并发症的发生率比较，无统计学意义。尿道瘘及尿道憩室经再次手术成形尿道治愈，尿道口狭窄经扩张尿道口改善。结论Snodgrass尿道成形术手术时间短，并发症少，并发症较容易处理，是治疗冠状沟及阴萃体中间型尿道下裂的合适手术方式。

Analysis of postoperative complication with Snodgrass Urethroplasty for coronal and Mid Penile Hypos-padias.

Objetive To summarize the postoperative complication and treatment of Snodgrass urethro- plasty in coronal and mid penile hypospadias repair. Methods In this retrospective study, we analyzed the medical records of 483 boys with coronal and mid penile hypospadias, who underwent Snodgrass urethroplasty between January 2006 to December 2010 in our institution. The details of the procedure are described and the postoperative outcome and treatment of complications are reviewed. Results Mean age of surgery was 4 years and 8 months （ range ： 8 months - 14 years）. Mean duration of surgery was 68 min （ range ： 40 - 100 min ）. The overall complication rate was 5.2 %. The rate of fistula, meatal stenosis, wound dehiscence, penile dis- tortion and urethral diverticulum occurrence was 3.5% , 2.3% , 1.0% ,2.1% and 0. 4% respectively. The difference between the incidence of complication after repair of coronal or mid penile hypospadias was found to he statistically insignificant （ P 〈 0. 05 ）. Urethral fistula and diverticulum needs to be repaired through reoperation. Urethral stenosis improve through urethral dilations. Conclusions Snodgrass urethroplasty is a quick, suitable both for coronal and mid penile hypospadias repair. The complications is very few and easy to deal with.