包皮皮瓣一期修复尿道下裂的经验

Experience of Hypospadias Stage I Repair Using Tranverse Cutting Islandform Prepuce Skin Flap

目的总结包皮皮瓣法修复尿道下裂的经验。方法对1997～2009年本科22例采用包皮皮瓣法进行尿道成形的尿道下裂患儿进行回顾性分析，其中1例联合用尿道口为基底的阴囊矩形皮瓣作尿道成形。结果本组病例均获随访，时间3个月～4年，阴茎外观良好，阴茎下弯矫正满意，排尿通畅。一次手术成功19例，占81．8％；术后尿瘘3例，2例经第二次手术修补后痊愈，1例自愈，尿道狭窄1例行狭窄段切除端端吻合痊愈。结论手术包皮皮瓣设计合理，掌握好适应证，手术技巧，加强术后处理，能获得良好的临床疗效。

Objective To summarize the experience of tranverse cutting the is landform prepuce skin flap technique applied to the hypospadias. Methods 22 children with hypospadias treated using urethroplasty with cross cutting is landform prepuce skin flap technique were reviewed. 1 case of them except that the opera- tion was carried out, they have a duplay throplasty by using scrotum rectangular skin flap with urethra orifice base operation. Results All the cases were follwed up for 3 months to 4 years, the appearance of peris of the children was normal, chordee of scrotum was satisfactory corrected, emiction unobstructed, once the operation success rate reached 81.8% （19cases） ,but 3 cases occurred urethral fistula complication, and 2 cases of them were well recovery after the second the operation, their urethral stricture improvement by normosthenuria. Conclusion The operation procedure is conform to anatomy-physiological feature, projection reasonableness, tranverse anastomotic continuious suture can obviously decrease urethral fistula morbidity. Specially hypospadias with chordee of scrotum, using cross cutting lslandform prepuce srin flap technique and quick pulse rectangular skin flap grafting on urethra orifice base is a better choice for the disease.