Zhang Linlin, Wu Dapeng, Chen Yule, He Dalin, Nan Xunyi
Department of Urology, First Affiliated Hospital, Medical College, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi Province, China.
Int Urol Nephrol. 2015 Mar;47(3):491-5. doi: 10.1007/s11255-015-0912-5. Epub 2015 Jan 23.
To evaluate the safety and efficacy of valgus mucosa anastomosis in posterior urethra reconstruction.
We retrospectively reviewed the medical records of 116 patients who had undergone anastomotic repair of posterior urethral strictures between 2009 and 2013. Seventy-six patients underwent valgus urethral mucosa anastomosis (group A), and 40 underwent traditional end-to-end anastomosis (group B). The voiding status, complication rate, and adjuvant therapy were compared between the two groups. The clinical outcome was considered a failure when any postoperative intervention was needed.
Patient age ranged from 11 to 68 years (mean 38.2 ± 10.6). Follow-up was 5-59 months (mean 19.5 ± 13.2). The estimated urethral stricture length was 0.5-3.5 cm (mean 1.85 ± 0.40). Of all patients, the number of patients with simple stricture and complicated stricture were 47 and 69 respectively, and there was no significant difference in the complexity of stricture between group A and group B (60.5 vs. 57.5%, P > 0.05). Besides, there was no significant difference in the follow-up time and length of stricture between the two groups (31.6 ± 12.0 vs. 35.1 ± 14.8 months, P > 0.05). Compared to group B, the operation success rate in group A was greatly improved (92.1 vs. 80%, P < 0.05), while the incidence of complication was similar between the two groups (31.6 vs. 27.5%, P > 0.05).
The valgus urethral mucosa anastomosis could significantly improve the operation success rate of end-to-end anastomosis, reduce the stricture recurrence rate, improve the long-term urination function, and not increase the incidence of complications. So, valgus urethral mucosa anastomosis is an easy, effective and reliable urethral anastomosis technique.
评估外翻黏膜吻合术在重建后尿道中的安全性和有效性。
我们回顾性分析了2009年至2013年间116例行后尿道狭窄吻合修复术患者的病历。76例患者接受外翻尿道黏膜吻合术(A组),40例接受传统端端吻合术(B组)。比较两组的排尿情况、并发症发生率及辅助治疗情况。若术后需要任何干预,则临床结果视为失败。
患者年龄为11至68岁(平均38.2±10.6岁)。随访时间为5至59个月(平均19.5±13.2个月)。估计尿道狭窄长度为0.5至3.5厘米(平均1.85±0.40厘米)。所有患者中,单纯狭窄患者47例,复杂性狭窄患者69例,A组和B组狭窄的复杂性无显著差异(60.5%对57.5%,P>0.05)。此外,两组的随访时间和狭窄长度无显著差异(31.6±12.0个月对35.1±14.8个月,P>0.05)。与B组相比,A组的手术成功率显著提高(92.1%对80%,P<0.05),而两组的并发症发生率相似(31.6%对27.5%,P>0.05)。
外翻尿道黏膜吻合术可显著提高端端吻合术的手术成功率,降低狭窄复发率,改善长期排尿功能,且不增加并发症发生率。因此,外翻尿道黏膜吻合术是一种简便、有效且可靠的尿道吻合技术。