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目的探讨提高Duckett术式治疗尿道下裂手术成功率的技术要点。方法2000至2008年采用Duckett手术Ⅰ期治疗尿道下裂共57例病例。分A组(2000年至2005年手术的)和B组(2006年至2008年手术的)进行手术成功率、尿瘘及尿道狭窄发生率的分析比较。结果B组手术成功率高于A组,尿瘘和尿道狭窄等并发症发生率更低(P<0.05)。结论Duckett手术要注意带血管蒂皮瓣的分离层面以及尿道管的缝合技术。血管蒂筋膜覆盖尿道管可以减少尿瘘发生。术中要注意消灭创面死腔。尿道吻合口和尿道外口缝合要宽敞。熟练掌握并灵活运用Duckett术式可以减少尿道下裂并发症的发生。
Objective To explore the technical points to improve the success rate of Duckett’s surgical treatment of hypospadias. Methods A total of 57 cases of hypospadias were treated with Duckett operation from 2000 to 2008. Analysis of the success rate of surgery, urinary fistula and urethral stricture in group A (surgery from 2000 to 2005) and in group B (surgery from 2006 to 2008) were compared. Results The success rate of operation in group B was higher than that in group A, and the complication rate of urinary fistula and urethral stricture was lower (P <0.05). Conclusions Duckett surgery should pay attention to the separation of the pedicled flaps and the urethral tube suture technique. Vascular pedicle fascial urethral tube can reduce the incidence of urinary fistula. Surgery should pay attention to eliminate the dead space. Urethra anastomosis and urethral suture should be spacious. Proficiency in and use of Duckett surgery can reduce the incidence of hypospadias complications.