尿道板纵切卷管尿道成形术的应用再思考

Some focal issues of applying tubularized incised plate for repairing hypospadias

尿道板纵切卷管尿道成形术(tubularized incised plate urethroplasty,TIP)现已成为修复中远段尿道下裂最常用的手术方法。该手术在经历模仿和广泛推广的过程中,一些应用问题日渐凸显,改进和限制指征引起人们的重视。如何进一步提高对手术技术的理解,更好地把握手术适应证,提高手术疗效仍然十分重要。本文结合文献和作者经验就TIP手术的改良及其对于减少尿道下裂手术并发症的贡献,以及手术后并发症的评价、手术适应证的再思考等进行阐述。

Tubularized incised plate(TIP)urethroplasty or Snodgrass has been the most common technique for repairing distal and middle types of hypospadias.However,many outstanding problems have arisen from its wider applications and emulations.Clinicians have come to realize the importance of modifications and restricted indications.And a thorough understanding of its technique aspects and a firm grasping of its surgical indications are vital for achieving better operative outcomes.Based upon literature reviews and personal experiences,the authors discussed its historical evolutions,technique refinements,efficacy evaluations,complication preventions and long-term follow-ups,etc.