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我们在尿道下裂手术后发生尿道皮肤瘘方面的23年经验。

Our 23-year experience in urethrocutaneous fistulas developing after hypospadias surgery.

作者信息

Sunay Melih, Dadali Mümtaz, Karabulut Ayhan, Emir Levent, Erol Demokan

机构信息

Clinic of 1st Urology, Ministry of Health Ankara Teaching and Research Hospital, Ankara, Turkey.

出版信息

Urology. 2007 Feb;69(2):366-8. doi: 10.1016/j.urology.2006.12.012.

Abstract

OBJECTIVES

To determine the role of the fistula characteristics on the outcomes of repair in urethrocutaneous fistulas that develop after hypospadias surgery.

METHODS

A total of 160 patients who had undergone urethrocutaneous fistula repair after hypospadias surgery were enrolled in this study. The prognostic significance of the site, size, and number of fistulas, number of the previous operations, and the techniques applied were analyzed by the appropriate statistical methods as the parameters of the study.

RESULTS

The fistulas were localized at the distal, mid, or proximal penile region in 69 (43.2%), 60 (37.5%), and 31 (19.2%) patients, respectively. No statistically significant relation was found between the fistula site and the success rate (P >0.05). The fistula size (2 mm or less versus greater than 2 mm) and the number of fistula repairs (single versus two or more) also did not affect the outcome (P >0.05, Pearson chi-square and Fisher's exact tests).

CONCLUSIONS

The site, size, and number of the fistula repair seemed to have no impact on the success rate. Well-known aspects of the modern hypospadias surgery (eg, delicate tissue handling, instruments, point coagulation, and vascularity of the tissues) probably play a role in the outcome.

摘要

目的

确定尿道下裂手术后发生的尿道皮肤瘘的瘘管特征对修复结果的作用。

方法

本研究纳入了160例尿道下裂手术后接受尿道皮肤瘘修复的患者。将瘘管的部位、大小和数量、既往手术次数以及所应用的技术作为研究参数,采用适当的统计方法分析其预后意义。

结果

瘘管分别位于阴茎远端、中段或近端区域的患者有69例(43.2%)、60例(37.5%)和31例(19.2%)。未发现瘘管部位与成功率之间存在统计学显著关系(P>0.05)。瘘管大小(2mm及以下与大于2mm)和瘘管修复次数(单次与两次或更多次)也未影响结果(P>0.05,Pearson卡方检验和Fisher精确检验)。

结论

瘘管修复的部位、大小和次数似乎对成功率没有影响。现代尿道下裂手术的一些众所周知的方面(如精细的组织处理、器械、点状凝血和组织的血管供应)可能对结果起作用。

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