口腔黏膜卷管游离移植一次性重建远段尿道

One-stage reconstruction of distal urethra with free graft of tublar oral mucosa

目的探讨应用口腔黏膜游离移植一次性重建远段尿道的方法，并观察治疗效果。方法在口腔两侧颊部各取1条宽0．4～0．6cm、长度和缺损尿道相当的颊部口腔黏膜，以空心的石蜡油绸布卷作为支撑，将黏膜相对合后缝合形成黏膜管，游离移植于缺损尿道的阴茎海绵体上，重建缺损的远段尿道，术后给予确实可靠的加压包扎及术后早期排尿等处理措施。结果2007年5月至2015年10月，共收治16例远段尿道缺损或狭窄患者，尿道缺损长度2—4cm，采用口腔黏膜游离移植一次性重建远段尿道，术后3例成年患者出现吻合口漏尿，其余患者恢复顺利。10例获电话随访，时间为1～5年，随访期间排尿通畅，未发生尿道狭窄。结论对不超过4cm的尿道远段缺损或狭窄，口腔黏膜游离移植重建是一简单、可靠的方法。

Objective To investigate the therapeuctic effect of one-stage reconstruction of distal urethra with free graft of tublar oral mucosa. Methods Two strips of oral mucosa graft（ 0.4-0.6 cm in width） , were harvested and sutured around an oiled silk roll to form mucosa tube. The mucosa tube was used to reconstruct distal urethra. Postoperative pressure dressing and earlier urination were recommended. Results From May 2007 to October 2015, 16 cases with distal urethra defect or stenosis were treated with this method. The urethra defect was 2--4 cm in length. Urethral fistula happened in 3 patients. All the other 13 cases healed primarily. 10 cases were followed up for 1--5 years by telephone with normal function. Conclusions One-stage reconstruction with free graft of bulbar oral mucosa is suitable and reliable for distal urethra defect less than 4 em in length.