Srivastava Anand, Dutta A, Jain D K
Senior Advisor (Surgery & Urology), Army Hospital (R&R), Delhi Cantt, India.
Classified Specialist (Surgery and Urology), Military Hospital, Jallandhar Cantt, India.
Med J Armed Forces India. 2013 Jan;69(1):16-20. doi: 10.1016/j.mjafi.2012.05.006. Epub 2012 Nov 30.
To present the feasibility of lingual mucosal graft urethroplasty in anterior urethral strictures and appraisal of donor site morbidity.
From November 2007 to December 2010, 14 patients underwent dorsal onlay lingual mucosal graft urethroplasty for anterior urethral strictures. Lingual mucosal graft was harvested from the lateral and undersurface of the tongue. Check micturating cystourethrograms were done 2 weeks after catheter removal and uroflowmetry after 3 months. Success was defined as normal uroflowmetry rates at 3 months in the absence of any postoperative instrumentation. Tongue was assessed for any residual pain, taste disturbances or restricted movement at 3 months.
Four patients had submucosal fibrosis of the oral cavity and their buccal mucosa was unfit for grafting. Mean (range) stricture length was 5 (3-16) cm and the operation time 170 (140-210) min. Graft width averaged 1.6 cm. Average length of harvested graft was 6.5 cm. Mean duration of follow-up was 12.8 months. Two patients developed stricture at the proximal anastomotic site. There were no donor site complications.
Lingual mucosal graft harvesting is simple, gives graft lengths comparable to buccal mucosa and is associated with negligible donor site morbidity.
介绍舌黏膜移植尿道成形术治疗前尿道狭窄的可行性及供区并发症评估。
2007年11月至2010年12月，14例患者接受背侧覆盖舌黏膜移植尿道成形术治疗前尿道狭窄。舌黏膜取自舌的外侧和下面。拔管后2周行排尿性膀胱尿道造影检查，3个月后行尿流率测定。成功定义为术后3个月尿流率正常且未进行任何术后器械操作。术后3个月评估舌部有无残留疼痛、味觉障碍或活动受限。
4例患者口腔黏膜下纤维化，颊黏膜不宜用于移植。狭窄平均长度（范围）为5（3 - 16）cm，手术时间170（140 - 210）分钟。移植片平均宽度为1.6 cm。采集的移植片平均长度为6.5 cm。平均随访时间为12.8个月。2例患者近端吻合口处出现狭窄。未发生供区并发症。
采集舌黏膜简单，获得的移植片长度与颊黏膜相当，且供区并发症可忽略不计。
