Watanabe K, Ogawa A, Kiyono M, Yoneyama T, Muraishi O
Department of Urology, Shinshu University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1994 Nov;85(11):1656-63. doi: 10.5980/jpnjurol1989.85.1656.
We reviewed 17 patients who had first undergone one-stage hypospadias repair. According to the criteria proposed by Keating and Duckett, the operative procedure performed was the MAGPI procedure in 2 patients, the pyramid procedure in 2, the Mathieu procedure in 1, the onlay island flap procedure in 6, the transverse preputial island flap and glans channel procedure (Duckett) in 4 and a combined method using the buccal and bladder mucosa graft in 2. The age of the patients ranged from 11 months to 22 years (median age 3.2 years). Postoperative follow-up ranged from 3 to 30 months (mean 7 months). Postoperative complications requiring revision occurred in 4 patients; urethrocutaneous fistula developed in 1 patient with the onlay island flap, urethral sticuture at the anastomosis and meatus in 1 patient with the transverse preputial island flap, meatal retraction in 1 patient with the mucosal graft, and urethral stricture at the distal anastomosis and bladder stone in the other patient with the mucosal graft. These complications were successfully revised by simple operations. Ventral skin tethering caused by scar contracture developed in 2 patients with the preputial island flap, and spontaneously improved with time in 1 patient. These results indicate that the criteria proposed by Keating and Duckett is proper to select an operative procedure for hypospadias.
我们回顾了17例首次接受一期尿道下裂修复术的患者。根据基廷和达克特提出的标准，所施行的手术方法为：2例患者采用尿道口前移阴茎头成形术（MAGPI），2例采用棱形术，1例采用马蒂厄术，6例采用加盖岛状皮瓣术，4例采用横行包皮岛状皮瓣与龟头隧道术（达克特术），2例采用颊黏膜和膀胱黏膜移植联合术。患者年龄为11个月至22岁（中位年龄3.2岁）。术后随访时间为3至30个月（平均7个月）。4例患者出现需要再次手术的术后并发症；1例采用加盖岛状皮瓣术的患者发生尿道皮肤瘘，1例采用横行包皮岛状皮瓣术的患者在吻合口和尿道口出现尿道狭窄，1例采用黏膜移植术的患者出现尿道口退缩，另1例采用黏膜移植术的患者在远端吻合口处出现尿道狭窄并伴有膀胱结石。这些并发症通过简单手术成功修复。2例采用包皮岛状皮瓣术的患者因瘢痕挛缩出现阴茎腹侧皮肤挛缩，其中1例患者随时间推移自行改善。这些结果表明，基廷和达克特提出的标准适用于选择尿道下裂的手术方法。
