Perović S, Brdar R, Scepanović D
Department of Paediatric Surgery and Urology, University Children's Hospital, Belgrade, Yugoslavia.
Br J Urol. 1992 Dec;70(6):678-82. doi: 10.1111/j.1464-410x.1992.tb15843.x.
Between August 1988 and December 1991, 36 children with bladder exstrophy underwent surgery for primary bladder reconstruction. Each child was either untreated or had already been treated unsuccessfully. The operative technique involved bilateral osteotomy of the superior ramus of the pubic bone. In infants the cartilaginous ischiopubic junction, acting as an articulation, allowed symphyseal approximation, while in older children this was achieved by fracture of the inferior ramus of the pubic bone. The bladder was either closed or, in most cases, the exstrophic bladder plate was inserted deep into the pelvis, allowing subsequent epithelialisation of the bladder and further formation and growth. Follow-up up for 3.5 years showed bladder capacities of 40 to 150 ml. Some patients underwent an additional augmentation enterocystoplasty. Primary bladder reconstruction remained uncompromised in 7 patients who developed moderate (and 1 complete) rediastasis of the pubic bones. All exstrophic bladders are reconstructible, particularly in older children.
1988年8月至1991年12月期间，36例膀胱外翻患儿接受了一期膀胱重建手术。每个患儿此前要么未接受过治疗，要么接受过但未成功。手术技术包括双侧耻骨上支截骨术。在婴儿中，软骨性耻骨联合作为一个关节，可实现耻骨联合的近似，而在大龄儿童中，则通过耻骨下支骨折来实现。膀胱要么被关闭，或者在大多数情况下，外翻的膀胱板被深深地插入盆腔，使膀胱随后上皮化，并进一步形成和生长。3.5年的随访显示膀胱容量为40至150毫升。一些患者还接受了额外的扩大性膀胱成形术。7例发生中度（1例完全性）耻骨再分离的患者，一期膀胱重建未受影响。所有外翻膀胱均可重建，尤其是大龄儿童。
