分期改良Koyanagi术在重型尿道下裂治疗中的应用  

Modified Koyanagi urethroplasty for severe hypospadia

作　　者：隋武[1] 姜志娥[1] 周致红[1] 苏海龙[1] 林洋[1] 

机构地区：[1]山东省烟台毓璜顶医院普外儿外科,山东省烟台市264000

出　　处：《临床小儿外科杂志》2012年第6期433-435,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨尿道板重建分期卷管尿道成形术（改良Koyanagi术）在重型尿道下裂矫治中的应用。方法回顾性分析2006年6月至2011年5月作者采用改良Koyanagi术治疗的15例重型尿道下裂患儿临床资料。年龄2岁11个月至6岁，平均3岁9个月。均于1年前行阴茎下曲矫正、尿道板重建术。入院后采取改良Koyanagi术，并与同期重型尿道下裂一期Duplay＋Duckett尿道成形术进行比较，术后随访7—24个月。结果15例患儿中，13例治愈，2例发生尿瘘，经尿瘘修补术治愈。无尿道狭窄。同期行Duplay＋Duckett尿道成形术14例，治愈10例，尿瘘3例，尿道狭窄1例。两种手术方法的成功率比较无统计学意义（P〉0．05）。结论尿道板重建分期卷管尿道成形术治疗重型尿道下裂，虽然需分期手术，但手术方法相对简单，容易掌握，并发症少，不易发生尿道狭窄。Objetive To evaluate the outcomes of two-stage modified Koyanagi procedure for severe hypospadias. Methods Records of 15 patients who underwent modified Koyanagi urethroplasty in Yantai Yuhangding Hospital from June 2006 to May 2011 were reviewed. The mean age was 3 years and 9 months （ 2 years and 11 months - 6 years）. All the patients underwent correction of penile curvature and urethral plate reconstruction more then one year ago. The surgical results and postoperative complications were retrospectively analyzed. Results The patients were foUowed-up for 7 - 24 months. 13 Cases were cured by modified Koyanagi procedure. Two cases had postoperative fistula and no stenosis . That were repaired successfully by one additional surgery. Ten cases were cured in 14 Duplay ＋ Duckett repaires, with complications of fistula in 3 cases and stenosis in 1 case. There was no significant difference between two groups （ P 〉 0.05）. Conclusions Two-stage modified Koyanagi urethroplasty is an efficient technique for severe hypospadias. It is relative easy with less complication.

关 键 词：尿道下裂 先天性 尿道下裂 外科学 

分 类 号：R696[医药卫生—泌尿科学]