阴囊纵隔皮瓣与阴囊中厚皮片对合移植Ⅰ期修复重型尿道下裂  

One-stage reconstruction for severe hypospadias using scrotal septal flap combined with scrotal split thickness skin graft

作　　者：林煌 李森恺 李养群 

机构地区：[1]中国医学科学院整形外科医院尿道下裂中心,北京100029

出　　处：《中华医学美学美容杂志》2009年第2期100-103,共4页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：基金项目：国家自然科学基金资助项目（编号：30070779）

摘　　要：目的探索一种可行的安全可靠的手术方法修复尿道，矫正重型尿道下裂畸形。方法对于严重型尿道下裂而阴囊发育正常的患者，运用阴囊纵隔岛状皮瓣同时对合取舍自阴囊的中厚皮片移植，Ⅰ期修复尿道治疗尿道下裂畸形。结果共计15例，术后随访1年，包括阴茎近端和阴茎阴囊及阴囊型尿道下裂，Ⅰ期完成治疗，治疗效果良好，没有尿道狭窄和尿瘘等并发症发生，手术后的尿道外口正位于阴茎头中央，阴茎矫直，无偏曲，排尿尿线直，尿道镜检查再造尿道内壁平整光滑。结论利用阴囊纵隔瓣对合阴囊中厚皮片Ⅰ期成形尿道，完成严重型尿道下裂的修复，效果可靠，操作简单，对合技术同时综合了皮片和皮瓣再造尿道的优点，并且能充分保证矫正阴茎下弯畸形，取得再造阴茎外观和功能上的满意疗效，是一种较理想的治疗手段。Objective The severe hypospadias is present with complicated deformity, and the successful rate of treatment is low with high complication rate. Here is to present a kind of useful and reliable treatment for it. Methods From 2004 to 2005, the scrotal septal island skin flap combined with the scrotal split thickness skin graft to form the neourethra in a stage was used to treat the hypospadias without underdeveloped scrotum. Results A total of 15 patients including proximal penile, penioscrotum and scrotal hypospadias who were followed up for about 1 year healed well without the occurrence of urethral stricture and urethral fistula, the penile curvature was corrected and the urine line was direct, and the endoscopic examination showed the inner wall of the urethra was smooth and intact. Conclusions The application of the scrotum septum flap combined with the scrotal splitted thickness skin graft to form the neourethra in one stage is reliable to treat the severe hypospadias with the simple procedure. The combined technique has obtained both the advantages of the skin graft and the skin flap to form the neourethra, and it could be used to correct the curvature of the penile. Thus the satisfactory result of the appearance and the function could be achieved . The technique is an excellent procedure.

关 键 词：尿道下裂 阴囊纵隔瓣 皮肤移植 

分 类 号：R726.9[医药卫生—儿科]