斜裁包皮带蒂皮瓣加会阴联合皮管治疗会阴型尿道下裂伴阴茎阴囊转位37例  

Oblique preputial pedicled skin flap plus perineum combined with percutaneous tube for treatment of 37 cases of hypospadia and penile scrotum transposition

作　　者：马达 吴国兴 吴锐发 姚志广 李耀军 林锦辉 王媛媛 许琴芳 MA Da;WU Guoxing;WU Ruifa;YAO Zhiguang;LI Yaojun;LIN Jinhui;WANG Yuanyuan;XU Qinfang(Department of Pediatric Surgery,Dongguan Children's Hospital in Guangdong Province,Dongguan523000,China)

机构地区：[1]广东省东莞市儿童医院小儿外科,广东东莞523000

出　　处：《中国现代医生》2019年第9期46-48,共3页China Modern Doctor

摘　　要：目的评价斜裁包皮带蒂皮瓣加会阴联合皮管治疗会阴型尿道下裂伴阴茎阴囊转位尿道成形术的疗效。方法回顾分析我院2015年1月～2018年5月收治会阴型尿道下裂伴阴茎阴囊转位患者37例,应用斜裁包皮带蒂皮瓣加会阴联合联合皮管治疗,其中15例加做膀胱造瘘术,分析术后疗效和并发症。结果手术成功率78.38%,平均手术时间(125.23±11.45)min,平均随访时间(6.21±1.84)个月,术后尿瘘率13.51%,吻合口狭窄率5.41%,尿道口狭窄率2.70%,并发症总体发生率21.62%;其余无憩室,无阴茎下弯,阴茎外观满意,均自正位尿道口排尿。结论斜裁包皮带蒂皮瓣加会阴联合皮管治疗会阴型尿道下裂伴阴茎阴囊转位基本都可以一次性完成手术。该方法具有取材方便、皮瓣血运可靠、并发症少、成形阴茎外观满意等优点,是较理想的手术方式。Objective To evaluate the efficacy of oblique preputial pedicled skin flap plus perineum combined with percutaneous tube in the urethroplasty of perineal hypospadia with penile scrotum transposition.Methods 37 cases of perineal hypospadia with penile scrotum transposition in our hospital from January 2015 to May 2018 were retrospectively analyzed.The patients were treated with oblique preputial pedicled skin flap plus perineum combined with percutaneous tube.Among them,15 cases were also treated with bladder ostomy.The postoperative outcomes and complications were analyzed.Results The surgical success rate was 78.38%;the average operation time was(125.23±11.45)min;the average follow-up time was(6.21±1.84)months;the postoperative urinary fistula rate was 13.51%;the anastomotic stenosis rate was 5.41%;and the urethral stricture rate was 2.70%.The overall incidence rate of complications was 21.62%.The rest did not have a diverticulum,no penis bent,and the appearance of the penis is satisfactory.Both of them urinated from the orthotopic urethra.Conclusion The oblique preputial pedicled skin flap plus perineum combined with percutaneous tube for the treatment of perineal hypospadia with penile scrotum transposition can basically complete the operation in one time.The method has the advantages of convenient material selection,reliable blood flow of the flap,less complications,satisfactory appearance of the formed penis,which is an ideal surgical method.

关 键 词：会阴型尿道下裂 阴茎阴囊转位 带蒂皮瓣 尿道成形术 

分 类 号：R726.9[医药卫生—儿科]