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一种治疗尿道皮肤瘘的简单方法;尿道下裂修复术后。

A simple procedure for management of urethrocutaneous fistulas; post-hypospadias repair.

作者信息

Mohamed S, Mohamed N, Esmael T, Khaled Sh

机构信息

Department of Plastic and Paediatric Surgery, Zagazig University Hospitals, Zagazig, Egypt.

出版信息

Afr J Paediatr Surg. 2010 May-Aug;7(2):124-8. doi: 10.4103/0189-6725.62844.

Abstract

OBJECTIVES

The treatment of urethral fistulas is quite challenging. We try to evaluate the results of a simple procedure in post-hypospadias urethral fistula repair.

MATERIALS AND METHODS

In the period from 2003 to 2007, 35 patients with 35 fistulas, with an average age 3.5 years [range: 2-8], were classified into coronal 12, mid-penile 13 and proximal 10. Based on the size they were grouped into two--either less than 5 mm (20) or more than 5 mm (15). Midline relaxing incision was used for large fistulas and then covered with a vascularised flap dartos-based flap [flip flap] in 19 and tunica vaginalis in 16. If a patient had more than one small fistula adjacent to each other, they were joined into a large single fistula and then repaired.

RESULTS

We have successfully repaired all urethrocutaneous fistulas using our protocol, with success rate [97.3] 1/35.

CONCLUSIONS

Dorsal midline urethral incision (DUMI), with dartos flip flap or tunica vaginalis coverage is an appropriate procedure to repair midline and proximal urethral fistulas.

摘要

目的

尿道瘘的治疗颇具挑战性。我们试图评估一种简单手术方法用于修复尿道下裂术后尿道瘘的效果。

材料与方法

2003年至2007年期间,35例患有35处瘘管的患者,平均年龄3.5岁[范围:2至8岁],其中冠状沟型12例,阴茎中段型13例,近端型10例。根据瘘管大小将患者分为两组——小于5毫米(20例)或大于5毫米(15例)。对于较大的瘘管采用中线松弛切口,然后分别用19例患者用带血管蒂的肉膜瓣[翻转瓣]覆盖,16例患者用鞘膜覆盖。如果患者有多个相邻的小瘘管,则将它们合并成一个大的单一瘘管再进行修复。

结果

我们按照方案成功修复了所有尿道皮肤瘘,成功率为97.3%(34/35)。

结论

采用肉膜翻转瓣或鞘膜覆盖的背侧中线尿道切开术(DUMI)是修复中线和近端尿道瘘的一种合适方法。

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