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单中心三级医疗机构尿道下裂手术的回顾性研究

Retrospective Study Over the Hypospadias Surgery in a Single Tertiary Center.

作者信息

Fruntelată Radu, Stoica George Alin, Ciobanu Mircea Ovidiu, Ciurea Marius Eugen, Nica Oliviu, Stoica Maria

机构信息

PhD Student, Department of Pediatric Surgery, University of Medicine and Pharmacy of Craiova, Romania.

Department of Pediatric Surgery, University of Medicine and Pharmacy of Craiova, Romania.

出版信息

Curr Health Sci J. 2021 Apr-Jun;47(2):177-183. doi: 10.12865/CHSJ.47.02.05. Epub 2021 Jun 30.

Abstract

UNLABELLED

Hypospadias surgery is a common activity in every department for pediatric surgery, increased incidence of this condition contributing this aspect. For this purpose permanent review of the data of cases is probably necessary, in order to promptly evaluate short and long term results.

MATERIAL AND METHODS

The authors are presenting this retrospective clinical and statistical study, enrolling 149 patients, hospitalized and operated in the Department of Pediatric Surgery and Orthopedics, between 2009 and 2018. several parameters were taken into consideration: moment of conception, type of hypospadias, associated malformations, use of meatoplasty, age at meatoplasty, age at urethroplasty, type of urethroplasty, postoperative incidents and complications.

RESULTS

Most of the patients included in the study were classified as anterior type of hypospadias, associated malformations were present in 20,13% of the patients, and 80% of the associated malformations belonged to the urogenital system. Over 60% of the cases underwent meatoplasty as a tactical procedure. Mathieu was the most appreciated procedure (74,5%) for urethroplasty and over a half of the patients were operated after the age of 3 years. Early and late postoperative fistula formation was noted in 18,12% of cases.

CONCLUSIONS

Better parameters to assess the exact type of hypospadias are needed to be introduced. Also, clear protocols for preoperative work-up in detection of other abnormalities, especially genito-urinary. Meatoplasty as a tactical procedure is having unclear influence for urethroplasty. Decreasing the age at urethroplasty should be the next goal. Some surgeons should really get overspecialized for this type of surgery.

摘要

未标注

尿道下裂手术是小儿外科各科室的常见手术,这种疾病发病率的上升促使了这一情况的出现。为此,可能有必要对病例数据进行长期审查,以便及时评估短期和长期结果。

材料与方法

作者呈现了这项回顾性临床和统计研究,纳入了2009年至2018年间在小儿外科和矫形外科住院并接受手术的149例患者。考虑了几个参数:受孕时间、尿道下裂类型、相关畸形、尿道口成形术的使用、尿道口成形术时的年龄、尿道成形术时的年龄、尿道成形术类型、术后事件和并发症。

结果

研究纳入的大多数患者被归类为前型尿道下裂,20.13%的患者存在相关畸形,其中80%的相关畸形属于泌尿生殖系统。超过60%的病例将尿道口成形术作为一种策略性手术。Mathieu术是最受青睐的尿道成形术(74.5%),超过一半的患者在3岁后接受手术。18.12%的病例出现了术后早期和晚期瘘管形成。

结论

需要引入更好的参数来评估尿道下裂的确切类型。此外,还需要明确的术前检查方案以检测其他异常情况,尤其是泌尿生殖系统的异常。尿道口成形术作为一种策略性手术对尿道成形术的影响尚不明确。降低尿道成形术的年龄应是下一个目标。一些外科医生在这类手术上确实过于专业化了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1c4/8551885/1ff3c22b58dd/CHSJ-47-02-177-fig1.jpg

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