不同术式修复尿道下裂5年诊治体会

The Five-year Experience of Using Different Surgical Treatments for Hypospadias

目的:总结不同术式治疗不同类型尿道下裂的经验和体会,为临床手术方式的选择提供参考。方法:对2009年至2014年收治的52例施行MAGPI、Onlay、Duckett、Duckett+Onlay、Flip+Flap、尿道成形合并膀胱黏膜成形术6种术式对3种类型尿道下裂进行回顾性分析。结果:6种术式因针对尿道下裂严重程度各部相同,通过对52例病例进行数据进行统计分析后得到的治愈率也不相同,其中MAGPI的手术成功率较高,术后尿道狭窄的发生率仅为25.0%且无尿瘘发生,而Flip+Flap术后尿道狭窄、尿瘘的发生率较高。结论:严格掌握手术适应症,根据患者尿道下裂的类型灵活选用不同术式,可提高手术成功率,降低手术并发症发生率。

Objective： To summarize the experience of using different surgical treatments for hypospadias and provide reference for the choice of clinical operations. Methods： This paper made a retrospective analysis of 52 cases of hypospadias from 2009 to 2014 treated by MAGPI, Onlay, Duckett, Duckett＋Onlay, Flip＋Flap and bladder mucosa grafting. Results： The cure rates of six treatments depended on the severity of hypospadias, according to the statistical analysis of 52 cases. The success rate of MAGPI was highest, with only 25.0% incidence rate of postoperative urethral stricture and no urinary fistula. The incidence rate of postoperative urethral stricture and urinary fistula was high with Flip＋Flap. Conlusion： It is suggested that operation indications should be grasped strictly and the operative method be determined flexibly according to the type of hypospadias in children, which could improve the success rate of surgery and reduce the incidence of surgical complications.