尿道修复手术失败后再手术经验回顾总结(“大家泌尿网”观看手术视频)

Experience of redo surgery of the failure cases undergone urethroplasty

经会阴尿道吻合术是目前治疗骨盆骨折尿道狭窄的重要方法之一,失败后的补救性手术仍以该入路为主。再手术患者的尿道近端与远端之间往往存在长段闭锁,单纯牵拉远近端难以达到无张力吻合,这是导致尿道吻合失败的主要原因。本文归纳总结了尿道修复手术失败的因素、失败后再手术的方法选择、术中细节以及常见技术难点的解决方案,以期促进尿道修复重建外科医生的理论和技术水平。

Transperineal urethral anastomosis is currently an important treatment method for urethral stricture after pelvic fracture.After failure,this approach is still the main remedial operation.There is often a long segment atretic between the proximal and distal urethra in patients undergoing reoperation,and it is difficult to achieve tension-free anastomosis by simply pulling the proximal and distal ends,which is one of the important reasons for urethral anastomosis failure.This paper summarizes the failure factors of urethral repair surgery,the choice of reoperation,intraoperative details and answers to common difficult problems,in order to promote the theory and technical level of reconstructive urethral surgeons.