Kambouri Katerina, Aggelidou Maria, Deftereos Savvas, Tsalikidis Christos, Chloropoulou Pelagia, Botaitis Sotirios, Giannakopoulos Stelios, Pitiakoudis Michail
Department of Anesthesiology, Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece.
Department of Radiology, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Alexandroupolis, Greece.
World J Plast Surg. 2020 Sep;9(3):254-258. doi: 10.29252/wjps.9.3.254.
Hypospadias repair is a challenging type of urogenital reconstructive surgery for which different techniques are currently used. The purpose of this study is to determine the outcomes of distal, mid-shaft and proximal hypospadias repair using two new variations of tubularized incised plate (TIP) urethroplasty (TIP-δ and TIP-ελ) and to compare their complication rates with other already known operative techniques made from the same surgical team.
This study included 269 boys with hypospadias. The preoperative meatal site was distal in 179 patients, mid-shaft in 44 and proximal in 46. The average age at the operation was 17 months. The technique applied in distal hypospadias was Mathieu in 77 patients, Snodgrass in 28 and (TIP)-δ in 74. The technique applied in mid-shaft hypospadias was a tubularized island flap (TIF) in 12 patients, onlay island flap (OIF) in 5 and TIP-ελ in 27. The operative technique for proximal hypospadias was TIF in 15 patients, OIF in 10 and TIP-ελ in 21. TIP-δ and TIP-ελ are two new variants of TIP operation that we have used in our clinic since 2010. Postoperative complications were recorded, and we compared the outcomes obtained by applying the techniques.
The use of TIP-δ in the distal hypospadias and long TIP-ελ in the mid-shaft and proximal hypospadias resulted in significantly fewer complications than the other surgical methods across all cases of hypospadias (<0.05).
The type of tissue used for neourethral coverage seems to play an important role in the outcome of hypospadias surgery.
尿道下裂修复是一种具有挑战性的泌尿生殖系统重建手术，目前采用不同的技术。本研究的目的是确定使用两种新型管状切开板（TIP）尿道成形术（TIP-δ和TIP-ελ）修复远端、中段和近端尿道下裂的结果，并将其并发症发生率与同一手术团队采用的其他已知手术技术进行比较。
本研究纳入了269例尿道下裂男孩。术前尿道口位置远端的有179例患者，中段的有44例，近端的有46例。手术平均年龄为17个月。远端尿道下裂采用的技术中，77例采用Mathieu术式，28例采用Snodgrass术式，74例采用（TIP）-δ术式。中段尿道下裂采用的技术中，12例采用管状岛状皮瓣（TIF），5例采用覆盖岛状皮瓣（OIF），27例采用TIP-ελ术式。近端尿道下裂的手术技术中，15例采用TIF，10例采用OIF，21例采用TIP-ελ术式。TIP-δ和TIP-ελ是我们自2010年以来在临床中使用的两种新型TIP手术变体。记录术后并发症，并比较应用这些技术获得的结果。
在所有尿道下裂病例中，远端尿道下裂使用TIP-δ以及中段和近端尿道下裂使用长TIP-ελ导致的并发症明显少于其他手术方法（<0.05）。
用于新尿道覆盖的组织类型似乎在尿道下裂手术结果中起重要作用。
