Furness P D, Cheng E Y, Franco I, Firlit C F
Department of Urology, Northwestern University Medical School, Children's Memorial Hospital, Chicago, Illinois, USA.
J Urol. 1998 Sep;160(3 Pt 2):1195-7; discussion 1216.
Various techniques of reconstruction have been developed to improve the cosmetic and functional status of the abdominal wall in the prune-belly syndrome. We describe a new extraperitoneal plication technique of abdominoplasty that is simplified in comparison to other established procedures in that it obviates the need for a fascial incision and/or entrance into the peritoneal cavity in patients who do not require a concurrent intra-abdominal procedure.
Since 1980 this technique of abdominoplasty has been performed in 13 patients 9 months to 11 years old (mean age 3.8) at 2 institutions. Seven patients underwent surgery before age 2.5 years. Abdominal wall reconstruction was performed as an isolated extraperitoneal procedure in 5 patients, while 8 had concomitant procedures performed with the abdominoplasty, including bilateral Fowler-Stephens orchiopexy in 7, ureteral reconstruction/reimplantation in 5, excision of urachal diverticulum or cyst in 2, reduction cystoplasty in 1 and Tenckhoff catheter placement in 1.
In all cases the cosmetic result was excellent and satisfactory to patients, parents and surgeons. Since the first procedure was performed 17 years ago, only 1 patient has returned with abdominal wall laxity or bulging in the area of repair.
Our method of abdominal wall reconstruction in the prune-belly syndrome produces a cosmetically excellent and durable result. In contrast to other techniques of abdominoplasty, the need for a fascial incision and/or entrance into the peritoneal cavity is avoided. We believe that this modified procedure offers distinct technical and anatomical advantages over other existing techniques.
已开发出多种重建技术，以改善梅干腹综合征患者腹壁的美观和功能状态。我们描述了一种新的腹壁整形腹膜外折叠技术，与其他既定手术相比，该技术得到了简化，因为对于不需要同时进行腹腔内手术的患者，它无需进行筋膜切口和/或进入腹腔。
自1980年以来，该腹壁整形技术已在两家机构对13例年龄在9个月至11岁（平均年龄3.8岁）的患者实施。7例患者在2.5岁之前接受了手术。5例患者将腹壁重建作为单独的腹膜外手术进行，而8例患者在腹壁整形手术同时进行了其他手术，包括7例双侧福勒 - 斯蒂芬斯睾丸固定术、5例输尿管重建/再植术、2例脐尿管憩室或囊肿切除术、1例膀胱缩小成形术和1例Tenckhoff导管置入术。
在所有病例中，美容效果均极佳，患者、家长和外科医生均感到满意。自17年前首次实施该手术以来，只有1例患者因修复区域腹壁松弛或膨出而返回。
我们在梅干腹综合征中进行腹壁重建的方法产生了极佳且持久的美容效果。与其他腹壁整形技术相比，避免了筋膜切口和/或进入腹腔的需要。我们认为，这种改良手术相对于其他现有技术具有明显的技术和解剖学优势。
