用显微外科技术矫治尿道下裂

MICROSURGICAL REPAIR OF HYPOSPADIAS

１９８６年至１９９３年，按照Ｔｈｉｅｒｓｃｈ法为８３例患者施行尿道成形术。其中６４例采用显微外科技术，１９例用传统的方法。结果显微外科组，一次手术成功率达８９．１％，术后发生局部感染８例，尿瘘４例，尿道狭窄３例。而传统方法组，一次手术成功率仅为４８％，术后发生局部感染８例，尿瘘８例，尿道狭窄１例。显微外科技术明显提高了手术成功率，可能与以下因素有关，显微外科技术操作精细，局部损伤小，成形尿道缝合准确，缝合时可不穿透皮肤，血运好，组织愈合好。此外，埋藏皮管的表面，皮肤、皮下组织分四层交错重叠缝合，可阻止尿道内分泌物的外渗，降低感染的发生率。

Abstract From 1986 to 1983, 73 cases of hypospadias were repaired by Thiersch method. In these patients, microsurgical technique was used in 64 cases and clasaical one in 19 cases. In the microsurgical group, 89. 1 per cent was successful. Post-operative complications were found in 8 cases of local infection, 4 cases of fistula and 3 cases of stenosis. 48 per cent was successful in classical gronp Post-operative complications were found in 8 cases of locali nfection, 8 cases of fistula and 1 case of stenosis. Therefore the microsurgical techniques were superior to the classical macrosurgical onee in performing urethroplasty. The advantages of sormer one were exact tissue handling, microdissection, fine suture material and accurate tissue approximation by four layers suture, which can prevent the urethral secretion from extravasating and decrease the infection rates.