尿道下裂修补术后并发症影响因素分析-第三军医大学学报.DOCVIP

不同来源皮瓣对近端尿道下裂修补术预后的影响 王瑞 于波涛 张卫星 秦俊昌 王磊 张杰 郑州大学第一附属医院泌尿外科；河南省高等学校临床医学重点学科开放实验室； （河南 郑州 450052） 摘要: 目的：比较不同来源皮瓣对于近端尿道下裂修补术预后的影响。 方法：于术后2年内随访包皮源性与阴囊中隔源性皮瓣行近端尿道下裂修补术后常见并发症的发生率，比较不同来源皮瓣预后有无差异，选择术式及手术次数对预后有无影响。 结果：共有54例患者完成随访，包括49例近端阴茎型及5例阴茎阴囊型。其中，31例行包皮源性皮瓣，23例应用阴囊中隔源性皮瓣。包皮源性皮瓣组卷管法比加盖法出现更多的尿线变细（p=0.028），但较低的阴茎下曲发生率（p=0.037）。在对其他两组间及组内常见并发症发生率之比较未见明显差异。结论：包皮源性皮瓣卷管法较包皮源性皮瓣加盖法出现更高的尿道狭窄及尿瘘并发症。包皮源性带蒂皮瓣与阴囊中隔带蒂皮瓣对近端尿道下裂修补预后影响无明显差别。 关键词：尿道下裂，术后并发症，包皮源性皮瓣，阴囊中隔源性皮瓣 Effect of different flaps on postoperative complication rate following proximal hypospadias repair Wang rui, Yu bo-tao, Zhang wei-xing, Qin jun-chang, Wang lei, Zhang jie Department of Urology,The FirstAffiliated Hospital of Zhengzhou University,Open Laboratory of Key Clinical Medical Disciplines for Henan Higher Education Institutions ,Zhengzhou Henan 450052,China Abstract Objective: The present retrospective study evaluated the flaps from different sources chosen to treat for hypospadia repair, and their relationship to postoperative complications. Methodology: This study was made subjected to hypospadia correction to evaluate different flaps on the hypospadia repair, and surgical techniques. They were followed up during 2y after operation for any postoperative complications. Results: The study was completed by 54 patients, containing 49 proximal penile and 5 penoscrotal. They were allocated into 2 groups according to different flaps, with preputial flaps used in 31 boys and scorotal septum flaps in 23.In repair performed with preputial flaps patients had higher risk of thinningz of urinary stream (p=0.028) but lower risk of penile chordee(p=0.037). Otherwise there was no significant difference in the complication rate of the various types of repair. Conclusions: There are significantly higher postoperative complications , such as urethral stricture and urinary fistula, when a tube rather an onlay is used in repairs performed with preputial flaps. Otherwise there was no significant difference in the complication rat