血管缝线双层皮内缝合法修补儿童尿道下裂术后尿瘘的临床观察

目的：探讨血管缝线双层皮内缝合法修补儿童先天性尿道下裂重建术后尿瘘的疗效。方法：需行尿瘘修补术的先天性尿道下裂患儿45例,均采用5-0血管缝线皮内缝合皮肤及尿瘘上皮各层,术后12d拆除双层血管缝线。结果：尿道远、中、近端单瘘修复成功率分别为75％、92％、89％,多瘘成功率81％,所有病例总失败率16％。失败的7例中5例在半年后再次适用此法修补尿瘘成功,2例再次行尿道下裂重建手术成功。术后随访时间3个月-3年（中位数2年）,无尿瘘复发。结论：血管缝线双层皮内缝合法对先天性尿道下裂重建术后尿瘘治疗效果尚可。

Double intradermal suturing of urethrocutaneous fistulas after hypospadias repair with vascular suture material

Objective： To investigate the effect of vascular suture in double intradermal suturing treating urethrocutaneous fistulas after hypospadias repair in children. Methods： A total of 45 cases with urethral fistula were treated. Double intradermal sutures with 5-0 vascular suture material were performed during the operation, which would be removed 12 days later. Results： The success rates were 75 %, 92 % and 89 % at the proximal, mid and distal region in single fistulas, respectively. The success rate was 81% in multiple fistulas. The total failure rate was 15.6 % （7 cases）, 5 cases needed reoperation utilizing the same suturing and 2 cases underwent urethroplasty for hypospadias, which all succeeded in the end. Follow-ups of patients ranged from 1 month to 3 years （the mean time was 2 years） and showed that all cases were cured with no recurrence. Conclusions： Double intradermal suturing with vascular suture material is acceptable in treating urethrocutaneous fistulas after hypospadias.