改良横裁岛状包皮瓣尿道成形术Ⅰ期修复阴茎型尿道下裂27例分析

对27例阴茎型尿道下裂患儿，横行裁取阴茎背侧岛状带蒂包皮瓣制成皮管，于血管蒂中部无血管区戳孔，穿过阴茎翻转至腹侧，与原尿道远端吻合。27例均Ⅰ期修复成功，术后并发尿瘘2例及尿道外口狭窄1例，阴茎外观满意。提示应用改良横裁岛状包皮瓣尿道成形术（Duckett术）Ⅰ期修复阴茎型尿道下裂，皮管缝合处紧贴阴茎腹侧白膜，两侧被血管蒂覆盖，极大地减少了尿瘘发生。

Analysis of 27 cases one stage repair of penile hypospadias with urethroplasty improved transverse cutting island prepuce flap

Twety seven children with penile hypospadias were treated using urethroplasty with transverse cutting island prepuce flap with local vascular pedicle from the dorsal penile rampant skin,and stabed hole at nonvascular region in middle of pedicle,reversed tubed flap through the penis to the ventral,anastomosed with the primary distal urethral.All cases were repaired successfully one stage,two cases with urethral fistula and one case with extemal orifice stricture of urethra.The appearance of the penis were satisfactory.It is suggested that one stage repair of penile hypospadias with urethroplasty improved transverse cutting island prepuce flap(Duckett's technique),the area of tubed flap sutured cling venial tunica albuginea penis,and bilateral is covered with vascular pedicle,greatly reduces the occurrence of urethral fistula.