重度尿道下裂的手术修复

The Repair of Severe Hypospadias

目的:介绍在重度尿道下裂修复中 Duckett+Duplay 手术的应用方法及特点。方法:对阴茎下弯矫正后,尿道缺损长的重度尿道下裂病例采用尿道口附近阴囊皮肤作 Duplay 尿道成形,再与 Duckett 岛状包皮瓣所作皮管吻合的联合手术方法,共修复重度尿道下裂42例,平均年龄2.9岁,术后随访6个月～3年。结果:42例中,一次手术成功32例(76.2%),8例尿瘘,1例尿道狭窄,1例成形尿道呈憩室状扩张。随访阴茎外观及排尿均良好。同期 Duckett 手术治疗249中治愈189例(75.9%)。两组治愈率无显著性差异(x^2=0.015,P>0.05)。结论:Duckett+Duplay手术对修复重度尿道下裂效果良好。尿瘘为其主要并发症。

Objective:To introduce Duckett-Duplay technique in repairing severe hypospadias. Methods:After release of chordee,there may be still a short length of the urethra.The neourethra can be constructed with a penile and scrotal skin tube by Duckett-Duplay technique. Forty-two cases(average age 2.9 yrs)were so treated.Results:Thirty-two cases cured after one operation(76.2%).Postoperative complications included fistula(8),urethral stricture(1)and urethral diverticulum(1).There are no significant differences between the results of Duckett plus Duplay and Duckett techniques.Conclusions:Duckett-Duplay technique is a preferable method in the treatment of severe hypospadias.