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近端尿道下裂的两阶段修复:700例病例回顾

Two Stages Repair of Proximal Hypospadias: Review of 700 Cases.

作者信息

Shukla Arvind Kumar, Singh Aditya Pratap, Sharma Pramila, Shukla Jyotsna

机构信息

Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India.

出版信息

J Indian Assoc Pediatr Surg. 2017 Jul-Sep;22(3):158-162. doi: 10.4103/0971-9261.207627.

Abstract

OBJECTIVE

Surgical repair of hypospadias is challenging and problematic even for the most experienced specialists, and this is especially true when severe and complicated case is confronted. Many operations had been described for the management of this deformity.

MATERIALS AND METHODS

During the period from May 2004 to December 2015, we performed 700 cases with proximal hypospadias, at our institute in the Department of Pediatric Surgery by a single surgeon. Data were collected retrospectively and included patient's age at operation, degree of the hypospadias, degree of associated chordee, complications, and cosmetic outcome. All patients underwent 2 two-stage procedures with 9-12 months interval in between.

RESULTS

Seven hundred patients with proximal hypospadias were operated upon in a period of 11 years. Byars's 2 two-stage operation was used in all 700 cases. Neither complete disruption nor urethral diverticula occurred 2 two-stage procedures in the 700 patients. 677 (96.7%) patients had no complication. Fistula was present in 21 (3%) patients. There was no case of meatal stenosis in our study.

CONCLUSION

Two stages procedure using the principles of Byar's technique is a versatile operation that can be used for 2 two-stage procedures the proximal hypospadias. It decreases the rate of fistula formation, disruption, and stenosis and gives a satisfactory cosmetic appearance.

摘要

目的

尿道下裂的手术修复即使对于最有经验的专家来说也具有挑战性且存在问题,尤其是遇到严重和复杂病例时更是如此。针对这种畸形的治疗已经描述了许多手术方法。

材料与方法

2004年5月至2015年12月期间,我们在我院小儿外科由一名外科医生对700例近端尿道下裂患者进行了手术。回顾性收集数据,包括患者手术时的年龄、尿道下裂程度、相关阴茎下弯程度、并发症及外观效果。所有患者均接受了两期手术,两期手术间隔9至12个月。

结果

在11年的时间里,对700例近端尿道下裂患者进行了手术。所有700例均采用拜尔斯两期手术。700例患者在两期手术中均未发生完全裂开或尿道憩室。677例(96.7%)患者无并发症。21例(3%)患者出现瘘管。本研究中无尿道口狭窄病例。

结论

采用拜尔斯技术原则的两期手术是一种通用手术,可用于近端尿道下裂的两期手术。它降低了瘘管形成、裂开和狭窄的发生率,并能获得令人满意的外观效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1b8/5473302/6a1373679351/JIAPS-22-158-g001.jpg

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