Evaluation of Tubularized Incised Plate Urethroplasty with Spongioplasty-Dartosoraphy Reinforcement in Pediatric Hypospadias: A Randomized Controlled Study.

IF 1.5 3区 医学 Q2 PEDIATRICS
European Journal of Pediatric Surgery Pub Date : 2024-12-01 Epub Date: 2024-01-23 DOI:10.1055/s-0044-1779277
Mohammad Daboos, Mohamed Abdelmaboud, Ahmed Azab, Mohamed Abdelaziz, Hany Eldamanhory
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引用次数: 0

Abstract

Introduction:  The original description of tubularized incised plate urethroplasty (TIPU) was provided by Snodgrass in 1994. The results were significantly improved by several modifications. To decrease the incidence of complications, interposing a vascularized flap after tubularization of the neourethra is recommended. The extent to which the type of interposed tissue has a direct effect on the rate of complications and cosmetic outcomes after TIPU repair is considered the answer to the main hypothesis of this study.

Materials and methods:  This prospective controlled randomized trial was conducted in the Department of Pediatric Surgery, Al-Azhar University, Cairo, Egypt, between May 2019 and May 2023. A total of 220 patients were included in this study. Patients were randomly assigned to either group A or group B. Group A included 110 patients who underwent TIPU with spongioplasty-dartosoraphy reinforcement. The other 110 patients (group B) underwent TIPU with dorsal dartos flap interposition, without spongioplasty.

Results:  Complications developed in 34 of 220 patients (15.4%). In group A, complications developed in 11 of 110 patients (10.0%). In group B, complications occurred in 23 of 110 patients (20.9%). Although the fistula rate, glanular dehiscence, disruption, and meatal stenosis were not significantly different between the study groups, the skin necrosis rate was significantly lower in group A than in group B. The overall complication rate was significantly lower in group A than in group B. Also, the difference in the mean Hypospadias Objective Scoring Evaluation between the two groups was statistically significant.

Conclusion:  TIPU with spongioplasty-dartosoraphy reinforcement is an effective modification of conventional TIPU. This modification appears to reduce the rate of complications and yield better cosmetic outcomes.

管状切口板尿道成形术与海绵体成形术-artosoraphy加固术在小儿尿道下裂中的应用评估:随机对照研究。
简介:斯诺德格拉斯(Snodgrass)于 1994 年首次描述了管状切开尿道成形术(TIPU)。经过多次修改后,手术效果有了明显改善。为了降低并发症的发生率,建议在新尿道管状化后插入血管瓣。插入组织的类型对 TIPU 修复术后并发症发生率和美容效果的直接影响程度被认为是本研究主要假设的答案:这项前瞻性对照随机试验于 2019 年 5 月至 2023 年 5 月期间在埃及开罗爱资哈尔大学小儿外科系进行。本研究共纳入 220 名患者。患者被随机分配到 A 组或 B 组。A 组包括 110 名接受了海绵成形术-artosoraphy 加固术的 TIPU 患者。另外110名患者(B组)接受了背侧达托皮瓣内插的TIPU手术,未进行海绵成形术:结果:220 例患者中有 34 例(15.4%)出现并发症。A 组 110 例患者中有 11 例(10.0%)出现并发症。B 组 110 例患者中有 23 例(20.9%)出现并发症。虽然研究组之间的瘘管率、龟头开裂率、中断率和肉阜狭窄率没有显著差异,但 A 组的皮肤坏死率明显低于 B 组:结论:采用海绵体成形术-artosoraphy加固术的TIPU是对传统TIPU的有效改进。结论:采用海绵体成形术-肛门成形术加固的 TIPU 是对传统 TIPU 的有效改良,这种改良似乎能降低并发症的发生率,并产生更好的外观效果。
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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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