A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair

A. Chakraborty, S. K. Majumdar, M. Zahid, S. M. Rahman, D. Saha, K. M. Hasan
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引用次数: 1

Abstract

Background/purpose: The tubularized incised plate urethroplasty (Snodgrass technique) presents the procedure of choice for distal hypospadias repair. Fistula formation is the most common complication with various rates. Avoiding overlap of suture lines in the Snodgrass repair is critical to minimize fistula formation through second-layer coverage of the neourethra. We compared the outcome of double- layer dartos flaps to flapless procedure in the tubularized incised plate urethroplasty for distal hypospadias repair to assess the effectiveness of dartos flap in this method. Methods: Our study included 28 patients aged upto 12 years who were treated with tubularized incised plate urethroplasty for distal hypospadias in Shaheed Suhrawardy Medical College Hospital from April 2010 to December 2011. They were divided into two groups. Group A (14 patients) had double dartos flap coverings. Group B (14 patients) had no dartos flap covering. The dissected dorsal dartos flap was bisected vertically to form two pedicle wings. Each wing was rotated laterally from either side of the glans to cover the neourethra ventrally in a double-layer fashion. Result: Mean follow up period was 9 months. In Group A, one patient (7%) developed fistula and one (7%) superficial skin necrosis. On the other hand three (21%) patients developed fistula and one patient (7%) meatal stenosis in group B, who were treated with Snodgrass procedure without using dartos flap. All successful repaired hypospadias patients of both groups had a cosmetically normal looking circumcised penis with ventrally slit meatus. Conclusions : Double dartos flaps covering of the neourethra is a simple procedure and could be effective for the prevention of urethrocutaneous fistula after tubularized incised plate urethroplasty. J. Paediatr. Surg. Bangladesh 3 (2): 65-70, 2012 (July)
双瓣管状切开钢板尿道成形术修复尿道下裂远端效果的比较研究
背景/目的:管状切开钢板尿道成形术(Snodgrass技术)是尿道下裂远端修复的首选方法。瘘管形成是最常见的并发症,发生率各不相同。在Snodgrass修复术中避免缝合线重叠是通过第二层覆盖神经尿道来减少瘘管形成的关键。我们比较了在尿道下裂远端管状切开钢板尿道成形术中使用双瓣和无瓣的效果,以评估双瓣在尿道下裂远端修复中的有效性。方法:本研究纳入2010年4月至2011年12月在Shaheed Suhrawardy医学院医院行输卵管切开钢板尿道成形术治疗尿道下裂远端患者28例,年龄不超过12岁。他们被分成两组。A组(14例)采用双瓣覆盖。B组14例无皮瓣覆盖。将解剖后的背蝶瓣垂直切开,形成两个带蒂的翅。每个翅膀从龟头两侧向外侧旋转,以双层方式覆盖神经咽喉。结果:平均随访9个月。A组1例(7%)出现瘘管,1例(7%)出现皮肤浅表性坏死。另一方面,B组3例(21%)患者出现瘘,1例(7%)患者出现金属狭窄,采用Snodgrass手术治疗,不使用皮瓣。两组成功修复的尿道下裂患者均具有外观正常的阴茎切包皮并伴有腹侧切口。结论:双皮瓣覆盖尿道是一种简便的方法,可有效预防管状切开钢板尿道成形术后尿道瘘的发生。j . Paediatr。孟加拉外科3 (2):65-70,2012 (7)
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