摘要
目的探讨显微外科技术在修复尿道下裂术后尿瘘治疗中的作用,以提高尿瘘修复成功率。方法1999年7月至2006年5月,对33例尿道下裂术后尿瘘的44个瘘口,应用显微外科技术,分别采用Thiersch偏心圆皮肤覆盖法修复28例;对伴发尿道狭窄、阴茎弯曲者5例,行阴茎瘢痕组织及狭窄尿道切除,以阴囊皮瓣重建尿道,阴茎皮瓣覆盖尿道。结果Thiersch法修复33个瘘口有5个复发;部分尿道切除加阴囊皮瓣尿道成形术修复5例,共11个瘘口,皮瓣全部成活,尿瘘无复发。结论应用显微外科技术可提高尿瘘修复的成功率,尿瘘修复的成功率还与瘘口局部情况、术式选择等有关。
Objective To evaluate the role of microsurgery in surgical treatment to urethrocutaneous fistula after urethroplasty in hypospadias and improve surgical results. Methods From 1999 to 2006,44 urethrocutaneous fistulae （ more than 3mm in diameter） after urethroplasty for hypospadias in 33 patients were repaired with different skin flaps. For example, Thiersch technique, urthroplasty, etc. Microsurgical technique was employed in every case. Results The success rates of different procedure were 84. 8% （28/33） for Thiersch technique, 100% （ 11/11 ） for urethroplasty respectively. The total success rate was 88.6% （39/ 44 ）. Conclusion It＇s just application of skin flap for repairing of big or complex urinary fistula ＇after hypospadias surgery. The application of microsurgical technique can increase success rate. It is necessary to excise scar and partial urethra for hypospadias fistula combined with urethral structures, cicatricial contracture and incurvation of penis. Rich blood-supply, low tension and atraumatic technique are all very important to improve surgery success rates of urinary fistula after hypospadias repair.
出处
《中华显微外科杂志》
CSCD
北大核心
2007年第2期99-101,I0003,共4页
Chinese Journal of Microsurgery
关键词
尿道下裂
尿瘘
显微外科手术
Urethrocutaneous fistula
Hypospadias
Microsurgical operation
