CAJ | 학술논문

目的探讨镶嵌式口腔黏膜尿道成形术治疗尿道下裂的效果. 方法 2005年1月至2010年12月343例尿道下裂患者行镶嵌式口腔黏膜尿道成形术.年龄6个月～61岁,平均7岁.初次手术147例,其中远端型尿道下裂124例,近端型23例;再手术196例,其中远端型尿道下裂137例,近端型59例.手术方法:将取下唇口腔黏膜补片填补于尿道板中间切开间隙,再将尿道板卷管成形尿道;切取口腔黏膜宽0.5 ～2.5 cm,长1.0～8.5 cm.对于再次手术病例,术中需切除瘢痕组织.结果术后随访6～36个月,平均16个月.147例初次手术病例中,手术成功132例(89.8％),发生尿瘘14例(9.5％),尿道狭窄2例(1.4％),其中1例近端型病例为尿瘘合并尿道狭窄.196例再手术病例中手术成功157例(80.1％),发生尿瘘32例(16.3％)、尿道狭窄13例(6.6％),其中1例远端型和5例近端型病例为尿瘘合并尿道狭窄. 结论尿道板切开后镶嵌口腔黏膜治疗尿道下裂具有成功率高,整形效果好,对口腔外观、功能无影响等优点.
목적 탐토양감식구강점막뇨도성형술치료뇨도하렬적효과. 방법 2005년1월지2010년12월343례뇨도하렬환자행양감식구강점막뇨도성형술.년령6개월～61세,평균7세.초차수술147례,기중원단형뇨도하렬124례,근단형23례;재수술196례,기중원단형뇨도하렬137례,근단형59례.수술방법:장취하진구강점막보편전보우뇨도판중간절개간극,재장뇨도판권관성형뇨도;절취구강점막관0.5 ～2.5 cm,장1.0～8.5 cm.대우재차수술병례,술중수절제반흔조직.결과 술후수방6～36개월,평균16개월.147례초차수술병례중,수술성공132례(89.8％),발생뇨루14례(9.5％),뇨도협착2례(1.4％),기중1례근단형병례위뇨루합병뇨도협착.196례재수술병례중수술성공157례(80.1％),발생뇨루32례(16.3％)、뇨도협착13례(6.6％),기중1례원단형화5례근단형병례위뇨루합병뇨도협착. 결론 뇨도판절개후양감구강점막치료뇨도하렬구유성공솔고,정형효과호,대구강외관、공능무영향등우점.
Objective To evaluate the effect of inlay buccal mucosa graft with tubularized incised urethral plates (TIP) urethroplasty for hypospadias repair. Methods From January 2005 to December 2010,a total of 343 cases of hypospadias underwent a buccal mucosa graft with TIP urethroplasty.The patients aged from 6 months to 61 years,mean 7 years.One hundred and forty-seven were primary surgery cases,and 196 cases had a history of failed surgery.In primary cases,124 were distal type and 23 were proximal type.There were 137 distal type cases and 59 proximal types in failed case group.A buccal mucosa graft was harvested from lower lip,fixed into the incised urethral plates in primary cases.In re-do cases,open urethral and remove scar tissue were necessary. Results The width of the buccal mucosa ranged 0.5 - 2.5 cm,length ranged 1.0 - 8.5 cm.All the patients were followed up for 6 - 36 months,average 16 months.In primary group,fistula occurred in 14 cases (9.5％ ),and urethral stricture in 2 cases (1.4％),in which 1 proximal case occurred both with urethral stricture and fistula; the overall success rate was 89.8％.In re-do group,fistula occurred in 32 cases ( 16.3％ ),and stricture in 13 cases (6.6％),in which 1 distal and 5 proximal cases occurred with both urethral stricture and fistula; the overall success rate was 80.1％. Conclusions Inlay buccal mucosal graft with TIP technique is an effective instrumentality for hypospadias repair because of its high successful rate,good cosmetic effect and without affecting on oral appearance and function in donor site.