【摘要】 目的比较长隧道分期尿道成形术与传统分期尿道成形术在男性重型尿道下裂的治疗效果。方法 2010-2013年中山大学附属第一医院小儿外科收治重型尿道下裂患者82例,其中21例行长隧道分期术式,余61例行传统分期术式,比较两组手术时间、出血量、术后患者生殖器外观满意度、尿瘘发生率、尿道狭窄发生率、尿道憩室发生率、阴囊分裂纠正率以及阴茎阴囊纠正率。结果长隧道组二期手术时间(70±20)min低于传统组(110±25)min,差异有统计学意义(P<0.05);术后随访长隧道组生殖器外观满意率(95.2%)及阴茎阴囊倒位纠正率(92.3%),高于传统组生殖器外观满意率(78.6%)及阴茎阴囊倒位纠正率(0.0%),差异有统计学意义(P<0.05);长隧道组尿瘘发生率(0.0%)低于传统组(13.1%),差异有统计学意义(P<0.05)。结论长隧道分期尿道成形术手术时间短,大大降低尿瘘的发生,可同时纠正阴囊分裂及阴茎阴囊倒位,生殖器外观改善满意,疗效优于传统术式。更多还原

【Abstract】 Objective To compare therapeutic effect between the long tunnel two-stage urethroplasty and traditional two-stage urethroplasty for proximal hypospadias. Methods 82 proximal hypospadias patients were treated in Pediatric Surgery of the First Affiliated Hospital of Sun Yat-sen University during 2010-2013. Long tunnel two-stage urethroplasty was operated on 21patients and 61 cases were treated with traditional two-stage urethroplasty. The operation time, blood loss, postoperative genitalia satisfaction, and the incidence of fistula, urethral stricture, urethral diverticulum as well as the correction rate of scrotal spilt and penoscrotal tansposition between these two groups were calculated and compared. Results The long tunnel group significantly decreased the operation time of second stage(70±20)min as compared to the traditional group [(110±25)min,P <0.05]. The postoperative genitalia satisfaction and correction rate of penoscrotal tansposition were higher in long tunnel group(95.2%, 92.3%) than the traditional group(78.6%, 0.0%, P<0.05). The incidence of fistula was markedly reduced in patients with long tunnel method(0.0%) when compared to the traditional group(13.1%, P<0.05). Conclusion Long tunnel two-stage urethroplasty can decrease the operation time, greatly reduce the incidence of fistula, meanwhile correct the scrotal spilt and penoscrotal tansposition as well as improve the appearance of genitalia, it is more effective than the traditional two-stage urethroplasty.更多还原