Dénes F T, Park R, Lopes R I, Moscardi P R M, Srougi M
Pediatric Urology Unit, Division of Urology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Pediatric Urology Unit, Division of Urology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
J Pediatr Urol. 2015 Oct;11(5):291-2. doi: 10.1016/j.jpurol.2015.06.006. Epub 2015 Jul 18.
Many patients with Prune Belly Syndrome (PBS) require abdominoplasty alone or in combination with correction of any urogenital abnormalities. This video presents a simplified technique with which to treat the abdominal flaccidity in PBS.
A longitudinal xypho-pubic fusiform figure is drawn on the abdomen, based on the area of skin and subcutaneous tissue to be removed. This is performed with preservation of the musculo-fascial layer and the umbilicus. A lateral elliptical single xypho-pubic line is drawn in the most lax side of the fascia, which is incised along this line. After urinary tract reconstruction and orchidopexy, closure is initiated by suturing the medial edge of the wider fascial flap laterally to the peritoneal side of the contralateral flap. Next, the now outer fascial flap is laid over the inner flap, and a buttonhole is made to expose the umbilicus. The subcutaneous tissue of the inner flap is laterally undermined to gain extra distance for the suture of the outer flap over the inner flap. The subcutaneous tissue and skin are sutured in the midline, incorporating the umbilicus.
In a 30-year period, 43 PBS patients underwent this procedure with good cosmetic and long-term functional results.
This abdominoplasty technique is simple and presents good functional and cosmetic results in PBS patients.
许多梅干腹综合征(PBS)患者仅需行腹壁成形术,或联合纠正任何泌尿生殖系统异常。本视频展示了一种治疗PBS患者腹部松弛的简化技术。
根据拟切除的皮肤和皮下组织区域,在腹部绘制一条纵向的剑突耻骨梭形图形。操作时保留肌筋膜层和脐部。在筋膜最松弛的一侧绘制一条外侧椭圆形单剑突耻骨线,并沿此线切开。在尿路重建和睾丸固定术后,通过将较宽筋膜瓣的内侧边缘横向缝合至对侧瓣的腹膜侧开始关闭。接下来,将现在的外侧筋膜瓣覆盖在内侧瓣上,并制作一个扣眼以露出脐部。在内侧瓣的皮下组织外侧进行潜行分离,以便为外侧瓣覆盖在内侧瓣上的缝合获得额外的距离。皮下组织和皮肤在中线缝合,将脐部纳入其中。
在30年期间,43例PBS患者接受了该手术,获得了良好的美容效果和长期功能效果。
这种腹壁成形术技术简单,在PBS患者中呈现出良好的功能和美容效果。