小儿尿道下裂术后尿瘘修补

Repair of Urethral Fistula Resulting from Hypospadias Operation

目的探讨各种方法修补尿道下裂术后尿瘘的一次成功率。方法38例尿道下裂术后尿瘘患者共59个瘘口,分别采用单纯结扎法(16例次)、切开缝合法(18例次)、Y-V皮瓣法(17例次)、Thiersch法(7例次)等修补,1个瘘口采用带蒂阴囊皮瓣法。结果手术一次成功率81.6%,各术式成功率分别为:单纯结扎法87.5%、切开缝合法66.6%、Y-V皮瓣法94.1%、Thiersch法85.7%。结论尿道下裂术后尿瘘的修补要根据瘘口的大小、部位、局部皮肤情况等选择不同的手术方式,选择合适的缝线,改尿道间断缝合为连续缝合及注意术后处理等可以提高手术一次成功率。Y-V皮瓣法及Thiersch法成功率较其它方法高,值得推广。

Objective To evaluate one-stage success rate of every method used to repair urethral fistula resulting from hypospadias operation. Methods There are 38 cases of urethral fistula and 59 fistulas in all.For 16 fistulas,simple ligation were adopted for the repair;for 18 fistulas,split-sewing were adopted for the repair;for 17 fistulas,Y-V shaped skin flaps were adopted for the repair;and for 7 fistulas,Thiersch method were adopted for the repair. Results The one-stage success rate of the repairs was 81.6%,and one-stage success rates of every methods above were 87.5%,66.6%,94.1%,and 85.7%. Conclusion The success rates of Y-V shaped skin flaps and Thiersch method were higher than those of other methods and worth to be pablicized.