CAJ | 학술논문

目的：探讨改良尿道板重建卷管尿道成形术（改良Koyanagi术）在重度尿道下裂矫治中的疗效。方法行改良Koyanagi术治疗的重型尿道下裂患儿35例为观察组，同期行Duckett+Duplay术治疗的重型尿道下裂患儿34例为对照组，比较2组的疗效。结果观察组手术时间明显短于对照组，差异有统计学意义（ P＜0.05）。2组1期治愈率、并发症发生率差异均无统计学意义（P＞0.05）。术后发生尿瘘患者6个月后均再次行瘘修补术成功治愈；发生不同程度的尿道狭窄患者均经1~3个月尿道扩张后可正常排尿。2组患者均随访6~24个月，平均15个月，均伸直满意，排尿通畅，连续6个月以上不需尿道扩张。结论改良的Koyanagi术治疗重型尿道下裂，手术方法容易掌握。
목적：탐토개량뇨도판중건권관뇨도성형술（개량Koyanagi술）재중도뇨도하렬교치중적료효。방법행개량Koyanagi술치료적중형뇨도하렬환인35례위관찰조，동기행Duckett+Duplay술치료적중형뇨도하렬환인34례위대조조，비교2조적료효。결과관찰조수술시간명현단우대조조，차이유통계학의의（ P＜0.05）。2조1기치유솔、병발증발생솔차이균무통계학의의（P＞0.05）。술후발생뇨루환자6개월후균재차행루수보술성공치유；발생불동정도적뇨도협착환자균경1~3개월뇨도확장후가정상배뇨。2조환자균수방6~24개월，평균15개월，균신직만의，배뇨통창，련속6개월이상불수뇨도확장。결론개량적Koyanagi술치료중형뇨도하렬，수술방법용역장악。
Objective To investigate the clinical effect of modified Koyanagi technique for the repair of severe hypospadias. Methods We retrospectively analyzed 35 patients with severe hypospadias treated by modified Koyanagi technique. And for comparison,34 cases of severe hypospadias treated with one-stage Duckett+Duplay technique in the same term were collected. Results The operation time of modified Koyanagi technique was much shorter than one-stage Duckett+Duplay technique,the result had statistically significance ( P < 0 . 05 ). The successful rate and complication in two groups had no statistically significance( P>0 . 05 ). The patients with urethral fistula were treated successfully with the repair of urethral fistula 6 months after the first surgery. And the cases of stenosis were cured by urethral dilatation within 1 to 3 months. All patients of the two group were followed up 6 to 24 months( mean 15 months). The correction of chordee and the micturition were very well,and did not need urethral dilation in 6 months at least. Conclusion Modified Koyanagi technique for the repair of severe hypospadias is relatively simple,has similar effect of surgery compared with Duckett+Duplay technique.