Ambriz-González Gabriela, Velázquez-Ramírez Gabriela A, García-González José Luis, de León-Gómez José Manuel García, Muciño-Hernández María Ivette, González-Ojeda Alejandro, Basterra Jaime Vargas
Department of Pediatric Surgery, Pediatric Hospital, Guadalajara, Mexico.
Urol Int. 2007;78(1):37-41. doi: 10.1159/000096932.
Urethrocutaneous fistulas (UCF) and flap dehiscence (FD) are the most common postoperative complications after hypospadias (HS) surgical repair. The aim of this study was to evaluate whether the application of fibrin sealant over the site of surgery and suture lines reduces these complications.
A prospective cohort of consecutive patients was treated over a 3-year period. 30 patients were submitted to HS surgical repair plus application of fibrin glue over the suture line and surgical site; for comparison, another 56 subjects made up the control group which was submitted to surgical repair only. Variables assessed included: age, type of HS, fibrin sealant used, complications and number of surgical procedures required to treat recurrences.
In general, the frequency of complications was 10 vs. 41% for UCF (p = 0.002), 13 vs. 50% for FD (p = 0.001), and for flap necrosis (FN) 6.7 vs. 28.6% (p = 0.01) for the treatment and control groups respectively. The number of surgical reinterventions to treat recurrences was higher in the control group than in the study group (p = 0.04).
The incidence of UCF after HS surgical repair can be reduced by applying fibrin sealant over the site of surgery and the suture lines.
尿道皮肤瘘（UCF）和皮瓣裂开（FD）是尿道下裂（HS）手术修复后最常见的术后并发症。本研究的目的是评估在手术部位和缝合线上应用纤维蛋白密封剂是否能减少这些并发症。
在3年期间对一组连续的前瞻性患者进行治疗。30例患者接受HS手术修复，并在缝合线和手术部位应用纤维蛋白胶；作为对照，另外56名受试者组成仅接受手术修复的对照组。评估的变量包括：年龄、HS类型、使用的纤维蛋白密封剂、并发症以及治疗复发所需的手术次数。
总体而言，治疗组和对照组的UCF并发症发生率分别为10%和41%（p = 0.002），FD分别为13%和50%（p = 0.001），皮瓣坏死（FN）分别为6.7%和28.6%（p = 0.01）。治疗复发的手术再次干预次数对照组高于研究组（p = 0.04）。
在手术部位和缝合线上应用纤维蛋白密封剂可降低HS手术修复后UCF的发生率。
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