背侧镶嵌口腔黏膜移植尿道成形术治疗尿道口狭窄：单中心经验
Treatment of Meatal Strictures by Dorsal Inlay Oral Mucosa Graft Urethroplasty: A Single-Center Experience.
作者信息
Wirtz Michel, Claeys Wietse, Francois Philippe, Waterloos Marjan, Waterschoot Mieke, Lumen Nicolaas
机构信息
Department of Urology, Ghent University Hospital, 9000 Gent, Belgium.
Centre Hospitalier de Mouscron, 7700 Mouscron, Belgium.
出版信息
J Clin Med. 2021 Sep 22;10(19):4312. doi: 10.3390/jcm10194312.
BACKGROUND
To report on the use of oral mucosa graft urethroplasty for meatal strictures using the dorsal inlay technique.
METHODS
Patients who underwent a single-stage dorsal inlay oral mucosal graft urethroplasty between January 2000 and May 2021 were included in this study. A follow-up of a minimum of 12 months was necessary for inclusion. Exclusion criteria were stricture extension into the penile urethra, concomitant stricture at another location, flap urethroplasty for a meatal stricture, dorsal inlay urethroplasty with another type of graft, ventral onlay graft urethroplasty or staged urethroplasty. Recurrence was defined by the inability to pass a 14F metal sound through the reconstructed meatus irrespective of patients' complaints.
RESULTS
Our study cohort included 40 patients. Buccal mucosal graft (BMG) urethroplasty was used in 25 patients and 15 patients were treated with the aid of lingual mucosal graft (LMG). The median follow-up was 85 (IQR: 69-110) months. Seven (17.5%) patients suffered a stricture recurrence of which four (10%) needed re-intervention. The median 5-y recurrent free survival (RFS) for the entire cohort was 85 (±6)%. The median 5-y RFS was 96 (±4)% versus 65 (±13)% for respectively BMG and LMG ( = 0.03). Post-operative complications were identified in 11 (27.5%) patients with only one (2.5%) patient who had a grade 3a complication.
CONCLUSIONS
Dorsal inlay oral mucosa graft urethroplasty is a safe and feasible technique for selected patients with meatal stenosis.
背景
报道采用背侧镶嵌技术的口腔黏膜移植尿道成形术治疗尿道口狭窄的应用情况。
方法
纳入2000年1月至2021年5月期间接受单阶段背侧镶嵌口腔黏膜移植尿道成形术的患者。纳入研究需要至少12个月的随访。排除标准包括狭窄延伸至阴茎尿道、其他部位合并狭窄、采用皮瓣尿道成形术治疗尿道口狭窄、采用其他类型移植物的背侧镶嵌尿道成形术、腹侧覆盖移植物尿道成形术或分期尿道成形术。无论患者有无主诉，若无法通过14F金属探子经重建尿道口，则定义为复发。
结果
我们参与研究的队列包括40例患者。25例患者采用颊黏膜移植（BMG）尿道成形术，15例患者采用舌黏膜移植（LMG）辅助治疗。中位随访时间为85（四分位间距：69 - 110）个月。7例（17.5%）患者出现狭窄复发，其中4例（10%）需要再次干预。整个队列的中位5年无复发生存率（RFS）为85（±6）%。BMG和LMG的中位5年RFS分别为96（±4）%和65（±13）%（P = 0.03）。11例（27.5%）患者出现术后并发症，仅1例（2.5%）患者出现3a级并发症。
结论
对于选定的尿道口狭窄患者，背侧镶嵌口腔黏膜移植尿道成形术是一种安全可行的技术。
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