横行带蒂岛状包皮瓣一期修复重度尿道下裂的效果

Efficacy of one-stage repair with horizontal preputial island flap for severe hypospadias

目的探讨横行带蒂岛状包皮瓣(Duckett术式)一期修复重度尿道下裂的临床效果。方法分析Duckett术式一期修复重度尿道下裂患者49例的临床资料。其中,单纯Duckett术式8例,Duckett联合原位尿道板卷(Duplay)术式18例,Duckett联合带蒂阴囊皮瓣转移法(Scrotal)术式23例。结果一期修复治愈40例;并发尿瘘7例,尿道狭窄1例,尿瘘合并尿道狭窄1例。Duckett联合Duplay术式与Duckett联合Scrotal术式一期修复成功率无统计学差异(77.8%vs.82.6%)(P>0.05)。结论 Duckett术式在重度尿道下裂的临床治疗中效果显著,对于尿道缺损长的患者可联合Duplay或Scrotal术式。

Objective To summarize the clinical efficacy of one-stage repair with horizontal preputial island flap（Duckett procedure） for severe hypospadias. Methods A total of 49 patients with severe hypospadias underwent Duckett procedure of one-stage repair, of whom 8 cases were operated with Duckett alone, 18 cases with Duekett＋ Duplay procedure and 23 cases with Duckett＋ Scrotal procedure. Results Forty patients were cured by one-stage urethroplasty. The rest had the complications of urethra fistula in 7 cases, urethra stenosis in one case and urethra fistula and stenosis in one case, There was no significant difference in the success rate of one-stage repair with horizontal preputial island flap between Duckett＋Duplay procedure and Duckett＋Scrotal procedure（77.8%vs. 82.6%）（P〉0. 05）. Conclusion Duckett procedure is effective for severe hypospadias and can be combined with Duplay or Scrotal procedure for the patients with longer urethral defect.