分支血管修复在尿道下裂duckett手术中的应用

Q4 Medicine

中华泌尿外科杂志 Pub Date : 2019-11-15 DOI:10.3760/CMA.J.ISSN.1000-6702.2019.11.004

Ling Yu, Jiewen Bao, Yan Chen, Huizhen Sun, Yiqing Lyu, Xiaoxi Li, Li Sun, Hua Xie, Fang Chen, Yi-Chen Huang

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The operative age, penile curvature, length of urethral defect, operation time, added value of coronary groove before and after operation, maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups, and the therapeutic effect was analyzed. \n \n \nResults \nThere was no statistically significant difference between two groups in operating time[(135±49)min vs.(135±45)min, P=0.580] and the value added of coronary sulcus[(0.1±0.2)cm vs.(0.1±0.1)cm, P=0.167]. In experimental group, there were 8 cases of urethra percutaneous fistula (11.8%) (coronary groove fistula in 3 cases, 4.4%)and 6 cases of urethral stenosis (8.8%) without urethral dehiscence. In control group, there were 18 cases of urethra percutaneous fistula (25.0%)(coronary groove fistula in 11 cases, 15.3%), 10 cases of urethral stenosis (13.9%), and 2 cases of urethral dehiscence (2.8%). 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According to different covering materials on newly formed urethra, the experimental group (68 cases) cut dysplasia, branched spongiosum and lateral Buck′s fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra, and the control group (72 cases) used Dartos fascia or subcutaneous fascia. The operative age, penile curvature, length of urethral defect, operation time, added value of coronary groove before and after operation, maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups, and the therapeutic effect was analyzed. \\n \\n \\nResults \\nThere was no statistically significant difference between two groups in operating time[(135±49)min vs.(135±45)min, P=0.580] and the value added of coronary sulcus[(0.1±0.2)cm vs.(0.1±0.1)cm, P=0.167]. 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引用次数: 0

摘要

目的探讨减少尿道下裂Duckett手术支海绵体修复术并发症的效果。方法回顾性分析2016年1月至2018年4月140例手术婴儿尿道下裂Duckett手术的临床资料。根据新尿道覆盖材料的不同，实验组(68例)从白膜处切开发育不良、支状海绵及外侧巴克氏筋膜至冠状沟处缝合新尿道，对照组(72例)采用达尔托斯筋膜或皮下筋膜缝合。比较两组患者的手术年龄、阴茎曲度、尿道缺损长度、手术时间、术前术后冠状沟附加值、最大尿流率及术后随访并发症发生率，并分析治疗效果。结果两组手术时间[(135±49)min vs(135±45)min, P=0.580]、冠状沟增加值[(0.1±0.2)cm vs(0.1±0.1)cm, P=0.167]差异无统计学意义。实验组经皮尿道瘘8例(11.8%)(冠状沟瘘3例，4.4%)，尿道狭窄6例(8.8%)，无尿道裂。对照组尿道经皮瘘18例(占25.0%)(冠状沟瘘11例，占15.3%)，尿道狭窄10例(占13.9%)，尿道裂2例(占2.8%)。实验组术后尿瘘发生率及总并发症均低于对照组，差异有统计学意义(P < 0.05)。实验组术后6个月最大尿流率显著高于对照组[(9.5±3.8)ml/s vs(6.8±2.8)ml/s]，差异有统计学意义(P<0.001)。结论尿道海绵体重建可显著降低尿道下裂Duckett手术后冠状沟瘘的发生率，提高术后尿流率。关键词:尿道下裂;从此之后;尿流率;跟进

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Application of branchedspongiosum repair in duckett surgery for hypospadias

Objective To explore the effect of reducing complication in branched spongiosum repair for hypospadias Duckett surgery. Methods Retrospective analysis was performed for the clinical data of 140 surgical infants with hypospadias Duckett surgery from January 2016 to April 2018. According to different covering materials on newly formed urethra, the experimental group (68 cases) cut dysplasia, branched spongiosum and lateral Buck′s fascia from tunica albuginea to coronary groove and then sutured over newly formed urethra, and the control group (72 cases) used Dartos fascia or subcutaneous fascia. The operative age, penile curvature, length of urethral defect, operation time, added value of coronary groove before and after operation, maximum urinary flow rate and complication rate of postoperative follow-up were compared between the two groups, and the therapeutic effect was analyzed. Results There was no statistically significant difference between two groups in operating time[(135±49)min vs.(135±45)min, P=0.580] and the value added of coronary sulcus[(0.1±0.2)cm vs.(0.1±0.1)cm, P=0.167]. In experimental group, there were 8 cases of urethra percutaneous fistula (11.8%) (coronary groove fistula in 3 cases, 4.4%)and 6 cases of urethral stenosis (8.8%) without urethral dehiscence. In control group, there were 18 cases of urethra percutaneous fistula (25.0%)(coronary groove fistula in 11 cases, 15.3%), 10 cases of urethral stenosis (13.9%), and 2 cases of urethral dehiscence (2.8%). The incidence of postoperative urinary fistula and total complications in experimental group was lower than that in the control group, and the difference was statistically significant (P 0.05). The maximum urine flow rate of experimental group at 6 months after surgery was significantly higher than control group[(9.5±3.8)ml/s vs.(6.8±2.8)ml/s], and the difference was statistically significant (P<0.001). Conclusions Urethral cavernosum reconstruction can significantly reduce the incidence of postoperative coronary groove fistula of hypospadias Duckett surgery and improve the postoperative urine flow rate. Key words: Hypospadias; Duckett; Urine flow rate; Follow up

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.