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Application of the Cecil-Culp repair for treatment of urethrocutaneous fistulas after hypospadias surgery.

机译:Cecil-Culp修复在尿道下裂手术后治疗尿道皮肤瘘中的应用。

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OBJECTIVES: To present our technique and results using a modification of the Cecil-Culp technique of hypospadias repair in a select group of boys with urethrocutaneous fistula during a 6-year period. Urethrocutaneous fistula remains the most common complication of hypospadias repair. Coverage of suture lines with vascularized tissue is thought to decrease fistula formation. METHODS: Between 1994 and 1999, 15 boys with hypospadias fistula underwent repair with a modified two-stage Cecil technique. The records were reviewed with respect to age, type of original hypospadias repair, number of previous fistulas, location of the fistulas, and complications. RESULTS: The average age at the time of the first stage of fistula repair was 3.5 years (range 1.8 to 6.0). Five, four, and two patients had undergone one, two, and three previous fistula repairs, respectively. Four boys in this series had deficient penile skin at the time of their first fistula repair. Most had one fistula at the time of the Cecil repair, including eight at the corona, four along the penile shaft, and three in a more proximal location. No patients had a recurrent fistula, with an average follow-up of 21 months (range 1 to 62). CONCLUSIONS: Boys with recurrent fistula, despite previous fistula repair, and deficient penile skin present a technical reconstructive challenge. The modified Cecil technique for fistula repair takes advantage of penile mobility to place it in a scrotal location, ensuring excellent vascularized tissue coverage. Although this technique requires a brief second-stage operation, no recurrent fistula has occurred in any of our patients.
机译:目的:通过对选择的一组患有尿道皮肤瘘的男孩在6年内使用尿道下裂修复术的Cecil-Culp技术进行改进,介绍我们的技术和结果。尿道皮肤瘘仍然是尿道下裂修复的最常见并发症。血管组织覆盖缝合线被认为可减少瘘管形成。方法:1994年至1999年,对15名患有尿道下裂瘘管的男孩进行了改良的两阶段塞西尔技术修复。审查了有关年龄,原始尿道下裂修复类型,既往瘘管数量,瘘管位置和并发症的记录。结果:瘘管修复第一阶段的平均年龄为3.5岁(范围为1.8到6.0)。五名,四名和两名患者分别接受过一,二和三次瘘管修补术。该系列中的四个男孩在第一次瘘管修复时阴茎皮肤不足。在塞西尔修复时,大多数瘘管有一个瘘管,其中在电晕处有八个瘘管,在阴茎干处有四个瘘管,在更近端的位置有三个瘘管。没有患者复发性瘘管,平均随访21个月(范围1至62)。结论:尽管先前曾进行过瘘管修复,但患有复发性瘘管的男孩以及阴茎皮肤不足的男孩仍面临技术性重建挑战。改良的Cecil瘘管修复技术利用阴茎活动性将其放置在阴囊位置,确保出色的血管化组织覆盖。尽管此技术需要简短的第二阶段手术,但我们的任何患者均未发生复发性瘘管。

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