改良Koyanagi手术治疗重型尿道下裂40例近期疗效分析  

Modified Koyanagi technique for one-stage repair of severe hypospadias： short-term efficacies

作　　者：康磊 张旭辉[2] 曾莉 马学 孟庆明[2] 陈柏峰[2] 张小学[2] 罗添华[2] 王计文[2] 

机构地区：[1]华西医院小儿外科,成都610041 [2]山西省儿童医院小儿泌尿外科

出　　处：《中华小儿外科杂志》2015年第3期187-191,共5页Chinese Journal of Pediatric Surgery

摘　　要：目的 探讨改良Koyanagi手术一期修复重型尿道下裂的手术方法及近期疗效.方法 回顾性分析2012年2月至2014年7月间采用改良Koyanagi手术一期修复重型尿道下裂患儿40例的临床资料.本组患儿年龄1.5～14岁,平均3.9岁.其中会阴型17例,阴囊型17例,交界型6例.结果 修复尿道长度3～7 cm,平均4.5 cm；术后随访3～28个月,平均7个月.术后发生并发症9例（22.5％）,其中尿瘘8例（20％）,远端尿道裂开1例（2.5％）.本组无尿道狭窄及憩室发生,阴茎阴囊外观和尿道功能满意.结论 本改良Koyanagi手术更加有利地保护了皮瓣、阴茎皮肤和包皮的血供,比较明显地简化了手术操作,并利用睾丸鞘膜瓣或阴囊肉膜瓣覆盖新尿道,有效减少了并发症的发生,近期疗效满意.Objective To explore the short-term efficacies of modified Koyanagi technique for one-stage repair of severe hypospadias.Methods Retrospective reviews were conducted for the clinical data of 40 patients undergoing modified Koyanagi procedure for severe hypospadias from February 2012 to July 2014.Their mean age was 3.9（1.5-14） years at the time of surgery.The types were scrotal （n =17）,perineal （n =17） and penoscrotal （n =6）.Results The mean length of neourethra was 4.5 （3-7） cm and the mean follow-up period 7 （3-28） 28 months.And the complications included urethrocutaneous fistulas （n =8,20%） and dehiscence of neourethra （n =1,2.5 %）.There was no onset of stricture or urethrocele.All patients achieved satisfactory cosmetic and urethral functional outcomes.Conclusions The modified Koyanagi technique may preserve the blood supply of flap and residual prepuce effectively and simplify the operation obviously.Also the use of tunica vaginalis flap or dartos flap reduces significantly the rate of complications.

关 键 词：尿道下裂 泌尿外科手术方法 男性 治疗结果 

分 类 号：R726.9[医药卫生—儿科]