摘要
目的 分析影响Duckett术式治疗尿道下裂的相关因素 ,探讨提高治愈率的治疗方法。方法 对Duckett术式进行改良 ,充分游离岛状皮瓣的血管蒂 ,使皮瓣转至阴茎腹侧后血管蒂较松 ,将皮管分别与近端尿道口斜形吻合及与龟头顶端吻合后 ,再把血管蒂远端筋膜向对侧铺开 ,与该侧阴茎白膜及尿道近端海绵体缝合固定 ,使皮管缝合缘两侧及尿道近端吻合口能完全覆盖于血管蒂筋膜之下。并对术后处理方法亦作改进。结果 术式改良前、后分别治疗 10 8例及 5 4例 ,一期治愈率由6 4.8%提高到 90 .7% (P <0 .0 1)。结论 本方法能增加新成形尿道及近端吻合口的组织覆盖面及厚度 ,保证良好的血供 ,减少并发症 ,提高治愈率。
Objective To search for factors related to successful hypospadias repair with Duckett technique. Methods With a modified Duckett technique, the blood pedicle of island flap was isolated thoroughly and transferred unrestrictedly to the ventral of the penis creating a neourethra on the tip of glans. The distal layer of the blood pedicle was loosed to cover the proximal corpus spongiosum and neourethra. Results 108 and 54 children of hypospadias were operated on with Duckett method and modified Duckett method separately. The successful rate in one stage repair by modified Duckett method was enhanced from 64.8% to 90.7% ( P < 0.01 ). Conclusion The modified Duckett technique can provide adequate blood pedicle flap covering the neourethra and the proximal anastomosis, diminish the postoperative complications, and increase the successful rate in one stage repair of hypospadias.
出处
《中华小儿外科杂志》
CSCD
2000年第6期349-351,共3页
Chinese Journal of Pediatric Surgery
