CAJ | 학술논문

目的评价分期手术治疗严重尿道下裂的效果.方法 2001年12月至2009年8月治疗27例严重尿道下裂患儿,年龄8个月至17岁,平均4.3岁.近端型伴重度阴茎下弯23例,既往手术失败组织挛缩4例.Ⅰ期手术:完全脱套包皮,切除阴茎腹侧纤维束带或瘢痕组织,完全伸直阴茎,游离带蒂岛状包皮内板转移至腹侧填补缺损,预置"尿道板",包皮内板缺乏侧取下唇口腔黏膜皮瓣.术后6个月Ⅱ期手术:手术方式采用尿道板纵切卷管尿道成形术.4例皮瓣与尿道板连接处出现瘢痕愈合,予瘢痕切除,口腔黏膜镶嵌后卷管成形尿道.结果 27例患儿中,无尿道狭窄、皮瓣坏死等发生,4例术后尿瘘,6个月后再修补.结论严重尿道下裂病例采用预置"尿道板"的分期手术,单次的手术操作简化,充分结合了传统尿道板卷管术式的优点,成功率高,整形效果好.
목적 평개분기수술치료엄중뇨도하렬적효과.방법 2001년12월지2009년8월치료27례엄중뇨도하렬환인,년령8개월지17세,평균4.3세.근단형반중도음경하만23례,기왕수술실패조직련축4례.Ⅰ기수술:완전탈투포피,절제음경복측섬유속대혹반흔조직,완전신직음경,유리대체도상포피내판전이지복측전보결손,예치"뇨도판",포피내판결핍측취하진구강점막피판.술후6개월Ⅱ기수술:수술방식채용뇨도판종절권관뇨도성형술.4례피판여뇨도판련접처출현반흔유합,여반흔절제,구강점막양감후권관성형뇨도.결과 27례환인중,무뇨도협착、피판배사등발생,4례술후뇨루,6개월후재수보.결론 엄중뇨도하렬병례채용예치"뇨도판"적분기수술,단차적수술조작간화,충분결합료전통뇨도판권관술식적우점,성공솔고,정형효과호.
Objective To evaluate the efficacy of two-stage repair in the surgical treatment of severe hypospadias. Methods From December 2001 to August 2009,29 patients with severe hypospadias underwent two-stage repair. Of the 29 patients,24 patients with proximal hypospdias complicated with serious penile curvature, and the other 5 had a history of failed previous surgery. At the first stage,orthoplasty was performed and the prepuce was repositioned ventrally, then free oral mucosal graft preplaced urethral plate. The second stage surgery was performed 6 months later,and tubularization of the replaced urethral plate was performed. Four patients underwent healing scar excision and inlay oral mucosal graft urethroplasty. Results No urethra stricture or "preplaced urethral plate" atrophy was noted. Fistula developed in 4 of 29 cases. Conclusions Two-stage repair is effective for severe hypospadias. Preplaced urethral plate at the first stage presents good clinical outcomes.