三角帆状阴茎皮瓣覆盖在尿道下裂修复术中的应用

Application of repairing that the hypospadia to be covered with triangular penis' flap

目的:探索一种在尿道重建后具有良好血运的、张力小的皮瓣覆盖方法,从而提高手术成功率、获得美观阴茎外形。方法:对66例先天性尿道下裂采用几种不同术式完成尿道重建、用三角帆状阴茎皮瓣覆盖方法,将新成形尿道完全错位掩盖在皮瓣下,缝合后与阴茎体长轴线成夹角斜线。结果:手术成功54例,随访6个月～5年,阴茎外形美观,避免因瘢痕挛缩致阴茎下弯,且皮瓣完整有一定厚度、血运良好,一旦手术失败形成狭窄或尿瘘需再次手术,可供质地良好的修复材料。结论:采用三角帆状皮瓣覆盖新成形尿道,方法简易,外形良好,有助于提高手术成功率,且为可能发生的尿瘘或尿道狭窄再修复预留下可用之优质皮肤材料。

Objective To search a method that a sort of have a good blood circulation and less tension after rebuild urethra,and then increase the success ratio of surgery. Methods We applied some different ways to do the surgery of rebuilding urethra for 66 congenital hypospadiacs. And used triangular penis′ flap cover and let the new molding urethra under the flap completely. And have an included angle slash with major axis of body＇s penis after oversew. Results 54 cases were successful, follow-up surveys for 6 months to 5 years, penis′ externality slinky,avoid cicatricial contracture result in penis sag, and flap have definite fly, good blood circulation, if the surgery unsuccessful, result in stricture and urinary fistula and have to do the surgery again,that can accommodate good repair material. Conclusion Using triangular flap cover urethra is an easy way, good externality, help increase the operation success ration, and can keep back the skin material for urinary fistula or urethra stricture.