Kumar Abhay, Das Suren K, Trivedi Sameer, Dwivedi Udai S, Singh Pratap B
Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Urol Int. 2010;84(1):78-83. doi: 10.1159/000273471. Epub 2010 Feb 17.
To compare the results of substitution urethroplasty and donor site morbidity between buccal mucosal graft (BMG) and lingual mucosal graft (LMG).
Patients who underwent single-stage dorsal onlay free oral mucosal graft substitution urethroplasty by Barbagli's technique between January 2004 and August 2008 were included in this study. Patients who underwent buccal (cheek, lip) mucosal graft urethroplasty were included in group I and those who underwent LMG urethroplasty (tongue) were included in group II. All patients underwent complete evaluation of the stricture including inspection of the oral cavity. Exclusion criteria were stricture length <3 cm and complex strictures which required a multistage procedure.
The results of urethroplasty were similar in both groups in terms of blood loss, duration of postoperative hospitalization, complications encountered at urethroplasty site, mean postoperative Q(max) and mean postoperative AUA symptom score. Early slurring of speech complications was seen in group II, but not in group I. The long-term complications of persistent oral discomfort, perioral numbness and tightness of the mouth were seen only in group I.
LMG urethroplasty is a good substitute for BMG urethroplasty with equally good results of urethroplasty with lower donor site morbidity.
比较颊黏膜移植（BMG）和舌黏膜移植（LMG）在替代尿道成形术的结果及供区并发症方面的差异。
本研究纳入了2004年1月至2008年8月期间采用Barbagli技术接受单阶段背侧覆盖游离口腔黏膜移植替代尿道成形术的患者。接受颊（脸颊、唇部）黏膜移植尿道成形术的患者纳入第一组，接受LMG尿道成形术（舌部）的患者纳入第二组。所有患者均接受了包括口腔检查在内的狭窄的全面评估。排除标准为狭窄长度<3 cm以及需要多阶段手术的复杂狭窄。
两组在失血、术后住院时间、尿道成形术部位遇到的并发症、术后平均最大尿流率（Q(max)）和术后平均美国泌尿外科学会（AUA）症状评分方面，尿道成形术的结果相似。第二组出现了早期言语含糊并发症，而第一组未出现。仅在第一组中观察到持续口腔不适、口周麻木和口部紧绷等长期并发症。
LMG尿道成形术是BMG尿道成形术的良好替代方法，尿道成形术效果同样良好，且供区并发症发生率较低。
