[Mathieu法与Snodgrass法尿道下裂修复术在远端尿道下裂修复中的比较]

[Comparison of the Mathieu and the Snodgrass urethroplasty in distal hypospadias repair].

作者信息

Guo Yunfei, Ma Geng, Ge Zheng

机构信息

Department of Urology, Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210008, China.

出版信息

Zhonghua Nan Ke Xue. 2004 Dec;10(12):916-8.

PMID:15638022

Abstract

OBJECTIVE

To compare the success rate, postoperative complications and cosmetic appearance of the perinatal flap (Mathieu) and the tubularized incised-plate (Snodgrass) urethroplasty in distal hypospadias repair.

METHODS

Between March 2001 and April 2004, Snodgrass-type repair was done in 36 patients and Mathieu-type repair in 43 patients with primary hypospadias either with or without minimal chordee.

RESULTS

The mean duration of surgery was significantly shorter for the Snodgrass procedure than for the Mathieu repair. With 3-10 months follow-up, the total numbers of complications of Snodgrass repair and Mathieu repair were 8 (22.2%) and 16 (37.2%) (P > 0.05), the fistula formation rates 8.3% and 25.6%, the meatal stricture formation rates 5.6% and 2.3%, and the wound dehiscence rates 8.3% and 2.3%, respectively. Flap necrosis was seen in 3 cases in the Mathieu group. Cosmetic appearance was highly satisfactory in the Snodgrass group.

CONCLUSION

The fistula and flap necrosis rates were lower and the surgery more convenient with the Snodgrass urethroplasty, which also had a better cosmetic outcome. The Snodgrass technique is recommended as a primary treatment to substitute Mathieu repair for distal hypospadias with or without minimal chordee.

摘要

目的

比较会阴皮瓣（马蒂厄）尿道成形术和管状切开板（斯诺德格拉斯）尿道成形术修复远端尿道下裂的成功率、术后并发症及外观效果。

方法

2001年3月至2004年4月期间，对36例原发性尿道下裂患者行斯诺德格拉斯式修复术，对43例原发性尿道下裂患者（伴有或不伴有轻度阴茎下弯）行马蒂厄式修复术。

结果

斯诺德格拉斯手术的平均手术时间明显短于马蒂厄修复术。随访3 - 10个月，斯诺德格拉斯修复术和马蒂厄修复术的并发症总数分别为8例（22.2%）和16例（37.2%）（P>0.05），瘘管形成率分别为8.3%和25.6%，尿道口狭窄形成率分别为5.6%和2.3%，伤口裂开率分别为8.3%和2.3%。马蒂厄组有3例出现皮瓣坏死。斯诺德格拉斯组的外观效果非常令人满意。