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背侧加腹侧联合双移植物尿道成形术在前尿道重建中的应用

Combined Dorsal Plus Ventral Double-Graft Urethroplasty in Anterior Urethral Reconstruction.

作者信息

Jiang Jianchun, Zhu Yuchun, Jiang Lihai, Luo Deyi, Wei Xin, Wazir Romel, Li Hong, Wang Kunjie

机构信息

Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu, 610041 Sichuan People's Republic of China ; Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province People's Republic of China ; Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan Province People's Republic of China.

Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu, 610041 Sichuan People's Republic of China.

出版信息

Indian J Surg. 2015 Dec;77(Suppl 3):996-1000. doi: 10.1007/s12262-014-1106-6. Epub 2014 May 27.

Abstract

This study aims to investigate the effect of combined dorsal plus ventral double-graft urethroplasty in anterior urethral reconstruction. Patients who underwent graft urethroplasty for anterior urethral strictures at West China Hospital from 2005 to 2010 were followed up with clinical evaluation. According to the site of graft fixed, patients were divided into single-onlay group (dorsal or ventral) and double-onlay group (dorsal plus ventral). Success rate and complications were compared between the two groups and were analyzed using t test and chi-square. A total of 77 patients completed the follow-up, 51 in single-onlay group and 26 in double group. There was no statistical difference in terms of age, length, site, stricture reason, and the type of graft used between the two groups. The mean follow-up time was 15.6 months (range from 4 to 33 months) in double group and 39.5 months (range from 15 to 59 months) in single group. The total success rate was 72.5 % in single-onlay group and 88.5 % in double-onlay group; no statistical difference existed (p > 0.05). Subgroup analysis shows the success rate was higher for double-onlay urethroplasty for the stricture of penoscrotal junction (88.9 vs 60.9 %, p < 0.05). The main postoperative complications including infection and urethrocutaneous fistula were not significant between the two groups (p > 0.05). Combined dorsal plus ventral double-graft urethroplasty showed a high success and low complication rate for anterior urethral strictures, especially for the penoscrotal junction.

摘要

本研究旨在探讨背侧加腹侧双片移植尿道成形术在前尿道重建中的效果。对2005年至2010年在华西医院因前尿道狭窄接受移植尿道成形术的患者进行临床随访评估。根据移植片固定部位,将患者分为单片移植组(背侧或腹侧)和双片移植组(背侧加腹侧)。比较两组的成功率和并发症,并采用t检验和卡方检验进行分析。共有77例患者完成随访,单片移植组51例,双片移植组26例。两组在年龄、狭窄长度、部位、狭窄原因及所用移植片类型方面无统计学差异。双片移植组平均随访时间为15.6个月(4至33个月),单片移植组为39.5个月(15至59个月)。单片移植组总成功率为72.5%,双片移植组为88.5%;无统计学差异(p>0.05)。亚组分析显示,双片移植尿道成形术治疗阴茎阴囊交界处狭窄的成功率更高(88.9%对60.9%,p<0.05)。两组术后主要并发症包括感染和尿道皮肤瘘无显著差异(p>0.05)。背侧加腹侧双片移植尿道成形术在前尿道狭窄治疗中显示出高成功率和低并发症率,尤其是对于阴茎阴囊交界处狭窄。

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