Division of Urology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Urology. 2012 Feb;79(2):443-7. doi: 10.1016/j.urology.2011.08.073. Epub 2011 Nov 25.
To determine the effect of closure versus nonclosure of the buccal mucosal graft harvest site in men undergoing bulbar urethroplasty in a randomized prospective study. The optimal postoperative management of the buccal mucosal graft donor site remains unknown.
A total of 50 consecutive patients were randomized to either donor site closure or leaving the donor site open. Postoperatively, questionnaires assessing pain, diet, salivation, perioral sensation, and mouth opening were completed daily for the first week and then monthly for 6 months. The primary endpoint was postoperative oral pain. The secondary endpoints were the interval to a regular diet, perioral numbness, changes in salivation, and interval to full mouth opening.
Of the 50 patients, 24 and 26 were randomized to the open and closed groups, respectively. The early postoperative pain scores demonstrated a trend favoring the nonclosure group until day 3 (4.1 vs 2.2; P=.07). At 6 months, no difference was found in the pain scores between the 2 groups (0.2 vs 0.3; P=.63). The return to a regular diet also favored the nonclosure group (70.8% vs 19.2% on day 1; P=.01) as did the return to full mouth opening (79.1% vs 15.3% on day 1; P=.001). Nonclosure resulted in less early perioral numbness (62.5% vs 92.3% on day 1; P=.008) and reduced the occurrence of bothersome numbness at 6 months (4.2% vs 23.2%; P=.05).
The results of the present randomized prospective trial suggest that leaving the buccal mucosa graft harvest site open leads to lower reported early pain scores, an earlier return to a full diet, an earlier return to full mouth opening, and a decrease in bothersome perioral numbness at 6 months postoperatively.
在一项随机前瞻性研究中，确定男性行球部尿道成形术后颊黏膜移植物供区关闭与不关闭的效果。颊黏膜供区的最佳术后处理仍不清楚。
50 例连续患者随机分为供区关闭组或供区开放组。术后，患者每天填写疼痛、饮食、流涎、口周感觉和张口度问卷，第 1 周每天填写，第 2 周到第 6 个月每月填写。主要终点是术后口腔疼痛。次要终点是恢复正常饮食的时间、口周麻木、流涎变化和完全张口的时间。
50 例患者中，24 例和 26 例患者分别随机分为开放组和关闭组。术后早期疼痛评分显示，非闭合组直到第 3 天（4.1 对 2.2；P=.07）更有利。6 个月时，两组间疼痛评分无差异（0.2 对 0.3；P=.63）。非闭合组也更早恢复正常饮食（第 1 天为 70.8%对 19.2%；P=.01）和完全张口（第 1 天为 79.1%对 15.3%；P=.001）。非闭合组早期口周麻木发生率较低（第 1 天为 62.5%对 92.3%；P=.008），6 个月时烦人口周麻木发生率降低（4.2%对 23.2%；P=.05）。
本随机前瞻性试验的结果表明，颊黏膜移植物供区开放可降低术后早期报告的疼痛评分，更早恢复正常饮食，更早恢复完全张口，6 个月后患侧口周麻木发生率降低。
