Leal M J, Monteiro C P, Barbosa J, Mendes J
Cirurgia Pediátrica, Hospital de Santa Maria, Lisboa.
Acta Med Port. 1990 Jul-Aug;3(4):221-7.
A review was made of 279 children with Hypospadias treated in Pediatric Surgery Department. Hypospadias was classified in accordance with existence of chordee and position of urethral meatus. Indications and the results are discussed according to Hypospadias type and surgical procedure performed over the years. Glanular Hypospadias (144 cases) were treated as follows: 117 by meatotomy or advancement meatoplasty and postectomy with 1.09 mean interventions per patient (M I/P). 24 by MAGPI procedure with 1,12 M I/P and 3 by other procedures. Distal penil Hypospadias without chordee (87 cases), 23 were treated by Denis Browne Crawford (DBC) procedure with 2,82 M I/P, 62 by Van Der Meulen procedure with 1,48 M I/P and 2 by other procedures. Hypospadias with chordee, penile and perineal (48 cases) 35 had chordee release followed by DBC procedure with 4,0 M I/P, 7 by Duckett procedure with 2,0 M I/P and 6 by other procedures. The present tendency towards the use of single stage procedures, namely MAGPI, Van Der Meulen and Duckett is analysed. Its advantages for patients and institutions--lower M I/P, decrease of hospitalization period, repair completed earlier in life and reduced emotional damage--are balanced with aesthetical results and frequency of complications.
对小儿外科治疗的279例尿道下裂患儿进行了回顾性研究。根据阴茎下弯的存在情况和尿道口位置对尿道下裂进行分类。根据尿道下裂类型和多年来实施的手术程序，讨论了手术指征和结果。阴茎头型尿道下裂（144例）的治疗方法如下：117例行尿道口切开术或尿道口前移成形术及尿道口后移术，每位患者平均手术干预次数（M I/P）为1.09次；24例行MAGPI手术，M I/P为1.12次；3例行其他手术。阴茎远端型尿道下裂无阴茎下弯（87例），23例行Denis Browne Crawford（DBC）手术，M I/P为2.82次；62例行Van Der Meulen手术，M I/P为1.48次；2例行其他手术。阴茎型和会阴型尿道下裂合并阴茎下弯（48例），35例行阴茎下弯矫正术，随后行DBC手术，M I/P为4.0次；7例行Duckett手术，M I/P为2.0次；6例行其他手术。分析了目前使用单阶段手术（即MAGPI、Van Der Meulen和Duckett手术）的趋势。其对患者和医疗机构的优势——较低的M I/P、缩短住院时间、在生命早期完成修复以及减少情感伤害——与美学效果和并发症发生率之间进行了权衡。
