Schmidt A H, Keenen T L, Tank E S, Bird C B, Beals R K
Division of Orthopedics and Rehabilitation, Oregon Health Sciences University, Portland 97201.
J Pediatr Orthop. 1993 Mar-Apr;13(2):214-9.
Twenty-five patients with bladder exstrophy underwent pelvic osteotomy at or before initial bladder closure and anterior abdominal repair. Ten patients underwent bilateral iliac osteotomies before 1977. An alternative procedure consisting of bilateral superior pubic ramotomies has been used in 15 patients since 1977. In all patients, successful tension-free closure of the abdomen was achieved. Long-term follow-up of these two groups of patients shows no difference in the degree of pubic diastasis, which was asymptomatic. Posterior iliac osteotomy requires two additional incisions, longer operative time, and postoperative immobilization. We therefore recommend bilateral superior pubic ramotomy as an alternative procedure in initial reconstruction of the anterior abdomen in patients with bladder exstrophy.
25例膀胱外翻患者在初次膀胱关闭及前腹壁修复时或之前接受了骨盆截骨术。1977年之前，10例患者接受了双侧髂骨截骨术。自1977年以来，15例患者采用了一种替代手术，即双侧耻骨上支切断术。所有患者均成功实现了无张力的腹部关闭。对这两组患者的长期随访显示，耻骨分离程度无差异，且均无症状。后髂骨截骨术需要额外做两个切口，手术时间更长，术后还需要固定。因此，我们建议在膀胱外翻患者前腹壁的初次重建中，采用双侧耻骨上支切断术作为替代手术。
