Ulman I, Erikçi V, Avanoğlu A, Gökdemir A
Department of Pediatric Surgery, Ege University Faculty of Medicine, Izmir, Turkey.
Eur J Pediatr Surg. 1997 Jun;7(3):156-7. doi: 10.1055/s-2008-1071079.
Ninety-seven children with distal hypospadias were treated surgically using perimeatal-based flap urethroplasty (Mathieu procedure) in a two and a half years period. A review of the medical records revealed two distinct groups of patients according to the suturing type and suture material. In the first group of 36 patients (group I), neourethra was constructed using 6/0 polyglactine (Vicryl) in a single layer, full-thickness, uninterrupted fashion. Skin flaps were approximated using interrupted simple 5/0 polyglactine (Vicryl) sutures. In the second group of 61 patients (group II), 7/0 polydioxanone (PDS) was used in the urethral anastomosis performed in a subcuticular, uninterrupted fashion. The skin flaps were closed using interrupted simple 5/0 rapidly absorbable polyglactine (Rapid Vicryl) sutures. Patients were followed-up from 6 to 12 months. Urethral or meatal stenosis was not observed in any patient. There was no infectious complication. Urethrocutaneous fistula rate was significantly higher in group I (16.6%) compared to group II (4.9%) (p < 0.01). Complication rate following hypospadias repair can be reduced by the use of a subcutaneous suture technique utilizing polydioxanone suture material in urethroplasties.
在两年半的时间里，对97例远端尿道下裂患儿采用基于尿道口的皮瓣尿道成形术（马蒂厄手术）进行手术治疗。回顾病历发现，根据缝合类型和缝合材料可将患者分为两个不同的组。在第一组36例患者（I组）中，新尿道采用6/0聚乙醇酸（薇乔）以单层、全层、不间断的方式构建。皮瓣用间断单纯5/0聚乙醇酸（薇乔）缝线缝合。在第二组61例患者（II组）中，尿道吻合采用7/0聚二氧杂环己酮（PDS）以皮下连续的方式进行。皮瓣用间断单纯5/0快速可吸收聚乙醇酸（速即纱）缝线关闭。对患者进行了6至12个月的随访。未观察到任何患者出现尿道或尿道口狭窄。无感染并发症。I组的尿道皮肤瘘发生率（16.6%）显著高于II组（4.9%）（p<0.01）。在尿道成形术中使用聚二氧杂环己酮缝合材料的皮下缝合技术可降低尿道下裂修复后的并发症发生率。
