横行带蒂岛状包皮瓣一期修复重度尿道下裂的效果

摘要

Objective To summarize the clinical efficacy of one-stage repair with horizontal preputial island flap(Duckett procedure) for severe hypospadias .Methods A total of 49 patients with severe hypospadias underwent Duckett procedure of one-stage repair ,of whom 8 cases were operated with Duckett alone ,18 cases with Duckett+ Duplay procedure and 23 cases with Duckett+ Scrotal procedure .Results Forty patients were cured by one-stage urethroplasty .The rest had the complications of urethra fistula in 7 cases ,urethra stenosis in one case and urethra fistula and stenosis in one case .There was no significant difference in the success rate of one-stage repair with horizontal preputial island flap between Duckett+Duplay procedure and Duckett+Scrotal procedure(77.8% vs . 82.6% )(P＞0 .05) .Conclusion Duckett procedure is effective for severe hypospadias and can be combined with Duplay or Scrotal procedure for the patients with longer urethral defect .%目的 探讨横行带蒂岛状包皮瓣(Duckett术式)一期修复重度尿道下裂的临床效果.方法 分析Duckett术式一期修复重度尿道下裂患者49例的临床资料.其中 ,单纯Duckett术式8例 ,Duckett联合原位尿道板卷(Duplay)术式18例 ,Duckett联合带蒂阴囊皮瓣转移法(Scrotal)术式23例.结果 一期修复治愈40例;并发尿瘘7例 ,尿道狭窄1例 ,尿瘘合并尿道狭窄1例.Duckett联合Duplay术式与Duckett联合 Scrotal术式一期修复成功率无统计学差异(77.8% vs .82.6% ) (P＞0 .05).结论 Duckett术式在重度尿道下裂的临床治疗中效果显著 ,对于尿道缺损长的患者可联合Duplay或Scrotal术式.