论文部分内容阅读
目的:舌黏膜镶嵌尿道成形术为多次尿道下裂手术失败患儿提供了一种尿道修补的新途径,并探索观察其疗效。方法:收集于2009～2014年在我院接受手术的患儿23例,平均年龄4.3岁。23例患儿阴茎局部条件差,多次术后观,尿道狭窄段及瘘口周围较多的瘢痕及挛缩组织,阴茎皮肤破坏严重。患儿均在6个月内接受过口腔黏膜(唇黏膜)代尿道成形术,术后失败,不考虑再次应用口腔黏膜重做尿道。根据入院时患儿手术失败的主要特点分为两组,尿道狭窄组10例,尿道瘘组13例。为再次手术来我院。23例患儿均接受舌黏膜镶嵌尿道成形术一期完成。所取黏膜的长度2～5cm,平均2.8cm;宽度0.5～1.0cm,平均0.7cm。术后随访5个月～2年,平均1.3年。结果:23例患儿发生尿道瘘1例(4.3%),尿道狭窄2例(8.7%),总体并发症率13.1%,手术成功率86.9%。其中尿道瘘组术后发生尿道瘘率1例(7.7%),术后尿道狭窄1例(7.7%),手术成功率84.6%(11/13);尿道狭窄组无一例发生术后尿道瘘,发生尿道狭窄1例(10.0%),手术成功率90.0%(9/10)。结论:多次尿道下裂手术失败的患儿,对于口腔黏膜替代材料不理想者,舌黏膜镶嵌尿道成形术为其提供了一种新的途径。
Objective: Tongue mucosa inlay urethroplasty provides a new way for urethral repair in children with multiple hypospadias failure, and to explore the efficacy. Methods: Twenty-three children undergoing surgery in our hospital from 2009 to 2014 were collected, with an average age of 4.3 years. 23 cases of children with poor local conditions of the penis, many postoperative view, urethral stricture and more scar and contracture around the fistula, the penile skin is severely damaged. Children received oral mucosa (lip mucosa) on behalf of urethroplasty within 6 months, failed after surgery, irrespective of re-application of oral mucosa to re-urethra. According to the main characteristics of the failure of children with admission to hospital were divided into two groups, urethral stricture group of 10 cases, urethral fistula group of 13 cases. To re-surgery to our hospital. Twenty-three infants underwent tongue-embedded urethroplasty in one phase. The length of the mucosa taken 2 ~ 5cm, an average of 2.8cm; width 0.5 ~ 1.0cm, an average of 0.7cm. Follow-up 5 months to 2 years, an average of 1.3 years. Results: Twenty - three cases had urethral fistula (4.3%) and urethral stricture (8.7%). The overall complication rate was 13.1%. The successful rate of operation was 86.9%. One case (7.7%) had urethral fistula after operation, one case (7.7%) had urethral stricture and the operation success rate was 84.6% (11/13). No urethral fistula was found in urethral stricture group, One case (10.0%) had urethral stricture, and the success rate was 90.0% (9/10). CONCLUSIONS: Children with multiple hypospadias failed to provide a new approach to urethroplasty with tongue-embedded urethroplasty in children with unsatisfactory oral mucosal replacement.