【摘要】 目的评价采用改良尿道板重建卷管尿道成形术(改良Koyanagi术)与Duckett+Duplay术Ⅰ期治疗近端型尿道下裂的临床效果。方法通过检索中、英文数据库及手工检索相关杂志,依据纳入、排除标准,按关键词进行搜索,选出符合要求的研究,使用Review Manage 5.3软件对提取的数据进行统计分析。结果本次研究共纳入5个符合要求的研究,包括行改良Koyanagi术的患者227例,行Duckett+Duplay术的患者235例。Meta分析结果显示,尿道瘘发生率及手术时间两组间差异无统计学意义。采用改良Koyanagi术术后尿道狭窄发生率相对较低(Z=3.01,P=0.003)。采用改良Koyanagi术的手术成功率较高(Z=2.09,P=0.04)。采用"网球拍"样皮瓣重建尿道板的改良Koyanagi术与Duckett+Duplay术尿道瘘发生率差异无统计学意义;改良Koyanagi术式的尿道狭窄发生率较低,手术成功率较高。采用背侧包皮纵行切开重建尿道板的改良Koyanagi术与Duckett+Duplay术术后尿道瘘、尿道狭窄的发生率及手术成功率差异无统计学意义。结论改良Koyanagi术相较于Duckett+Dupaly术Ⅰ期治疗近端型尿道下裂术后尿道狭窄的发生率较低,且手术成功率较高。更多还原

【Abstract】 Objective To evaluate the clinical effect of modified Koyanagi technique and Duckett+Duplay technique in the treatment of proximal hypospadias. Methods In this study, we searched Chinese and English databases and manually searched relevant journals. According to the inclusion and exclusion criteria, we searched by keywords to select the research that met the requirements. We used review manage 5.3 software to analyze the extracted data. Results Five eligible studies were included in this study, including 227 patients with modified Koyanagi technique and 235 patients with Duckett+Duplay technique. The results of meta analysis showed the incidence of urethral fistula and operation time: there was no statistical difference between two groups. Incidence of urethral stricture: the incidence of urethral stricture after modified Koyanagi technique was relatively low(Z=3.01, P=0.003). Operation success rate: the operation success rate of modified Koyanagi technique was higher(Z=2.09, P=0.04). There was no significant difference in the incidence of urethra fistula between the modified Koyanagi technique and Duckett+Duplay technique with the "tennis racket" flap reconstruction of urethra plate; the incidence of urethra stenosis and the success rate of the modified Koyanagi technique were lower and higher. There was no significant difference in the incidence and success rate of urethra fistula and stricture between the modified Koyanagi technique and Duckett+Duplay technique. Conclusion Compared with Duckett+dupaly technique, the modified Koyanagi technique has a lower incidence of urethral stricture and a higher success rate.更多还原