尿道下裂手术方法选择

摘要

目的 探讨不同类型尿道下裂手术方法的疗效。 方法 总结分析手术治疗1435例首诊尿道下裂病例资料。 结果 一次手术成功例数：合并阴茎下弯者，采用Duckett带蒂岛状包皮瓣尿道成形术506/748例(67.6%)，DenisBrowne皮条埋藏法224/332例(67.5%)，阴囊中间皮肤岛状皮瓣法36/37例(97.3%)，游离移植物法21/42例(50%)；无合并阴茎下弯者采用MAGPI术式92/95例(96.8%)，Mathieu法146/165例(88.5%)，King法6/7例(85.7%)，Onlay加盖岛状皮瓣法6/9例(66.7%)。 结论 尿道下裂的修复应根据有无合并阴茎下弯及病人的具体条件选择手术方法。%Objectives To evaluate different surgical procedures forhypospadias repair. Methods 1 435 cases of hypospadias treated from 1973 to 1998 were retrospectively analyzed.MAGPI,Mathieu,King and Onlay island flap procedures were undertaken for hypospadias without chordee.Preputial island flap (Duckett),Denis Browne,scrotal island flap and free graft techniques were adopted for hypospadias with chordee. Results The success rate for Duckett was 67.6% (506/748),Denis Browne 67.5% (224/332),scrotal island flap 97.3% (36/37),free graft 50.0% (21/42),MAGPI 96.8% (92/95),Mathieu 88.5% (146/165),King 85.7% (6/7),Onlay island flap 66.7% (6/9). Conclusions The choice of surgical procedure for hypospadias repair should be individualized.Dukett procedure is recomman-ded for hypospadias with chordee and MAGPI,Mathieu,King or Onlay island flap for hypospadias without chordee according to the location of the meatus.