CAJ | 학술논문

目的探讨改良的尿道板重建卷管尿道成形术(Koyanagi)结合睾丸鞘膜覆盖,在重度尿道下裂矫治中的应用.方法选取49例重度尿道下裂患儿,随机分为2组,25例采用改良Koyanagi术结合睾丸鞘膜覆盖治疗,24例行Duplay+ Duckett尿道成形术,比较2组的手术效果及术后并发症的发生情况.结果 25例行改良的Koyanagi术患儿中,20例治愈;3例发生尿瘘,6个月后经尿瘘修补术治愈;2例尿道狭窄,经1～3个月尿道扩张后可正常排尿.24例行Duplay+ Duckett尿道成形术的患儿,治愈17例;尿瘘4例,6个月后经尿瘘修补术治愈;尿道狭窄3例,经1～3个月尿道扩张后可正常排尿.2种手术方法的成功率比较,差异无统计学意义(P ＞0 05).结论改良的Koyanagi术治疗重度尿道下裂,手术方法相对简单,结合睾丸鞘膜覆盖可进一步降低并发症的发生率.
목적 탐토개량적뇨도판중건권관뇨도성형술(Koyanagi)결합고환초막복개,재중도뇨도하렬교치중적응용.방법 선취49례중도뇨도하렬환인,수궤분위2조,25례채용개량Koyanagi술결합고환초막복개치료,24례행Duplay+ Duckett뇨도성형술,비교2조적수술효과급술후병발증적발생정황.결과 25례행개량적Koyanagi술환인중,20례치유;3례발생뇨루,6개월후경뇨루수보술치유;2례뇨도협착,경1～3개월뇨도확장후가정상배뇨.24례행Duplay+ Duckett뇨도성형술적환인,치유17례;뇨루4례,6개월후경뇨루수보술치유;뇨도협착3례,경1～3개월뇨도확장후가정상배뇨.2충수술방법적성공솔비교,차이무통계학의의(P ＞0 05).결론 개량적Koyanagi술치료중도뇨도하렬,수술방법상대간단,결합고환초막복개가진일보강저병발증적발생솔.
Objective To investigate the clinical effect of modified Koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias.Methods 49 cases with severe hypospadias treated from Jan.2009 to Sep.2011 were retrospectively studied.25 patients underwent Koyanagi technique with coverage by tunica vaginalis of testis.24 cases underwent one-stage Duplay + Duckett technique in the same term.The patients were followed up for 7-24 months.Results Among the 25 children treated with Koyanagi procedure,20 cases were cured,5 patients had postoperative complications,including urethral fistula in 3 cases,urethral stenosis in 2 cases.At the same time,in the Duplay + Duckett group,17 cases were cured,7 children had postoperative complications,including urethral fistula in 4 cases,and urethral stenosis in 3 cases.All the patients with urethral fistula were repaired successfully 6 months after the first surgery; The urethral stenosis were cured by dilatation within 1 to 3 months.The successful rate in the 2 groups had no significant difference(P ＞ 0 05).Conclusions Koyanagi technique with coverage by tunica vaginalis of testis is relatively simple with similar effect as Duplay + Duckett technique for severe hypospadias.