Center for Reconstructive Urethral Surgery, Arezzo, Italy.
Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
J Urol. 2014 Mar;191(3):688-93. doi: 10.1016/j.juro.2013.09.006. Epub 2013 Sep 11.
We investigated the early and late complications after oral mucosal graft harvesting, and reported the independent predictors of outcome via multivariable analysis.
We performed a retrospective descriptive study of 553 patients from whom an oral mucosa graft was harvested for urethroplasty from single or bilateral cheeks. Patients who underwent oral mucosa harvesting from the lip, the tongue or from the cheek and lip at the same time were excluded from analysis. The oral graft was harvested in an ovoid shape with closure of the wound. Postoperative early and late complications were investigated using a self-administered, nonvalidated, semiquantitative questionnaire. There were 6 questions on early complications, and 13 questions investigated late complications and patient satisfaction.
Descriptive statistics of categorical variables focused on frequencies and proportions. Univariable and multivariable analyses were used to predict early and late dissatisfaction of patients. Bleeding was reported in 3.4% of patients. Overall 53.2% of patients did not report any pain and 36.3% reported no swelling. Late complications analysis showed that 95.5% of patients declared that the surgical closure of the wound did not cause any difficulty in opening the mouth or problems with smiling (98.2%) and/or dry mouth (95.8%). Overall 98.2% of patients were satisfied with the procedure. Univariable and multivariable analyses revealed that bilateral graft harvesting was the only significant predictor of patient dissatisfaction (OR 2.85, p = 0.01 and OR 2.72, p = 0.02; respectively).
Harvesting the oral mucosa ovoid graft from a single cheek with closure of the wound is a safe procedure with high rates of patient satisfaction.
我们调查了口腔黏膜移植术后的早期和晚期并发症,并通过多变量分析报告了结果的独立预测因素。
我们对 553 名患者进行了回顾性描述性研究,这些患者因尿道成形术而从单侧或双侧颊部采集口腔黏膜移植物。排除了同时从唇部、舌部或颊部和唇部采集口腔黏膜移植物的患者。口腔移植物以卵圆形形状采集,并闭合伤口。使用自我管理的、未经验证的半定量问卷调查术后早期和晚期并发症。有 6 个关于早期并发症的问题,13 个问题调查晚期并发症和患者满意度。
分类变量的描述性统计数据侧重于频率和比例。单变量和多变量分析用于预测患者的早期和晚期不满。报告有 3.4%的患者出现出血。总体而言,53.2%的患者没有任何疼痛,36.3%的患者没有肿胀。晚期并发症分析显示,95.5%的患者表示手术闭合伤口不会导致张口困难或微笑问题(98.2%)和/或口干(95.8%)。总体而言,98.2%的患者对手术过程感到满意。单变量和多变量分析显示,双侧移植物采集是患者不满的唯一显著预测因素(OR 2.85,p=0.01 和 OR 2.72,p=0.02;分别)。
用闭合伤口从单侧颊部采集口腔黏膜卵圆形移植物是一种安全的手术,患者满意度高。