Virasoro Ramón, Zuckerman Jack M, McCammon Kurt A, DeLong Jessica M, Tonkin Jeremy B, Capiel Leandro, Rovegno Agustín R, Favre Gabriel, Giudice Carlos R, Eltahawy Ehab A, Gur Uri, Jordan Gerald H
Eastern Virginia Medical School, Norfolk, VA, USA.
Department of Urology, Eastern Virginia Medical School, 225 Clearfield Avenue, Virginia Beach, VA, 23462, USA.
World J Urol. 2015 Dec;33(12):2153-7. doi: 10.1007/s00345-015-1512-9. Epub 2015 Feb 18.
To present mid-term outcomes from an international, multi-institutional cohort of patients undergoing vessel-sparing excision and primary anastomosis urethroplasty for the reconstruction of the anterior urethra.
From June 2003 to December 2011, 68 patients underwent vessel-sparing anterior urethral reconstruction at five different international institutions using the vessel-sparing technique described by Jordan et al. (J Urol 177(5):1799-1802, 2007).
Patients' age range was from 3 to 82 years (mean 51.2). Stricture length ranged from 1 to 3 cm (mean 1.78). After a mean follow-up of 17.6 months, 95.6 % of patients had a widely patent urethral lumen. Three patients failed the procedure, requiring either direct vision internal urethrotomy or urethral dilation, after which all were free of symptoms and did not require further instrumentation. Complications were minimal and as expected following open urethroplasty.
Preservation of blood supply is a noble pursuit in surgery; however, it can be technically difficult and often requires more time and effort. This vessel-sparing technique for anterior urethral reconstruction is reproducible and appears to be reliable in this international cohort. Larger studies and longer follow-up are needed to support these encouraging results.
展示一组接受保留血管切除术和一期吻合尿道成形术以重建前尿道的国际多机构患者的中期结果。
2003年6月至2011年12月，68例患者在五个不同的国际机构接受了保留血管的前尿道重建手术，采用了Jordan等人描述的保留血管技术（《泌尿学杂志》177(5):1799 - 1802, 2007）。
患者年龄范围为3至82岁（平均51.2岁）。狭窄长度为1至3厘米（平均1.78厘米）。平均随访17.6个月后，95.6%的患者尿道腔广泛通畅。3例患者手术失败，需要直视下内切开或尿道扩张，之后所有患者均无症状，无需进一步器械操作。并发症极少，与开放性尿道成形术后预期的情况相同。
保留血供是手术中的一项崇高追求；然而，这在技术上可能具有挑战性，并且通常需要更多时间和精力。这种用于前尿道重建的保留血管技术具有可重复性，在这个国际队列中似乎是可靠的。需要更大规模的研究和更长时间的随访来支持这些令人鼓舞的结果。
