Chrzan Rafal, Dik Pieter, Klijn Aart J, de Jong Tom P V M
Department of Pediatric Urology, University Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Urology. 2007 Jul;70(1):148-52. doi: 10.1016/j.urology.2007.01.103.
To assess outcomes in hypospadias repair at our institution, as compared with the literature, with repair technique and surgeon considered as risk factors.
The results of 299 primary hypospadias corrections were analyzed. All procedures were performed by three experienced pediatric urologists. Mean patient age at operation was 16.3 months. Follow-up was between 6 months and 5.5 years. Distal hypospadias repair was carried out in 242 patients, with tubularized incised plate reconstruction in 100 patients, advancement in 128, and the Mathieu technique in 14.
During follow-up, complications occurred overall in 93 patients (31%). For distal hypospadias complications occurred in 59 patients (24%). The most common findings for distal hypospadias were urethral fistulas (14.4%). The complication rate depended on the severity of the anomaly (0 glanular, 28% pericoronal, and 63% proximal) and the chosen technique (16% advancement technique versus 60% tubular techniques). We found statistically significant differences in complication rates between operating surgeons.
Complications after hypospadias surgery are frequent. They are multifactorial and depend mainly on the type of the anomaly, the chosen technique, and the experience of the surgeon. More studies are needed to obtain an internationally accepted quality indicator for the outcome of hypospadias repair.
与文献报道相比，评估我院尿道下裂修复手术的结果，将修复技术和外科医生视为风险因素。
分析299例原发性尿道下裂矫正手术的结果。所有手术均由三位经验丰富的小儿泌尿外科医生进行。手术时患者的平均年龄为16.3个月。随访时间为6个月至5.5年。242例患者进行了远端尿道下裂修复，其中100例行管状切开板重建术，128例行推进术，14例行马蒂厄技术。
随访期间，93例患者（31%）出现并发症。远端尿道下裂患者中有59例（24%）出现并发症。远端尿道下裂最常见的表现是尿道瘘（14.4%）。并发症发生率取决于畸形的严重程度（龟头型为0，冠状沟周围型为28%，近端型为63%）和所选择的技术（推进技术为16%，管状技术为60%）。我们发现手术医生之间的并发症发生率存在统计学上的显著差异。
尿道下裂手术后并发症很常见。它们是多因素的，主要取决于畸形类型、所选择的技术和外科医生的经验。需要更多的研究来获得国际认可的尿道下裂修复结果质量指标。
