加盖岛状皮瓣法在小儿尿道下裂手术中的应用

The application of urethroplasty using the Onlay island flap technique in treatment of pediatric hypospadias

目的探讨加盖岛状皮瓣法尿道成形术治疗小儿尿道下裂的临床疗效。方法对105例尿道下裂患儿(病理类型为冠状沟型35例,阴茎体型68例,阴茎阴囊交界型2例,均伴有轻中度阴茎下弯)采用加盖岛状皮瓣法尿道成形的方法,正位修复尿道下裂。结果 105例尿道下裂患儿中,95例术后痊愈,7例术后14~21 d发生尿瘘,3例发生轻度尿道外口狭窄,未发现尿道憩室、切口裂开等情况,手术成功率为90.5%。所有患儿均获随访,随访时间半年~1年,阴茎外观和排尿均正常。结论加盖岛状皮瓣法尿道成形术正位修复尿道下裂,适用于伴有轻中度阴茎下弯的尿道下裂,手术成功率高,并发症少,值得临床推广。

Objective To evaluate the clinical efficacy and safety of urethroplasty using the Onlay island flap technique in the treatment of pediatric hypospadias. Methods In total,105 cases of hypospadias（ pathologically diagnosed with coronary sulcus type in 35 cases,penis size in 68 and penis scrotal boundary type in 2 accompanied with mild to moderate penile curvature） underwent urethroplasty using the Onlay island flap technique. Results Among 105 patients,95 cases were recovered after surgery,7 cases developed fistula at postoperative 14 to 21 days,3 cases had mild urethral stricture and no urethral diverticulum or incision was found. The success rate of surgery was 90. 5%. All patients were followed up for 6 months to 1 year. The penis appearance and urination were normal. Conclusions Urethroplasty using the Onlay island flap technique is efficacious and safe in the orthopedic repair of hypospadias with mild to moderate penile curvature. The success rate of surgery is high and the risk of postoperative complications is low,which is worthy of clinical application.