Chao Min,Zhang Yin,Jiang Jiabin,et al.Application experiences of integral covering technique of Buck’s fascia plus glans wings during tubularized incised plate urethroplasty for restoring normal penile anatomy of hypospadias[J].Journal of Clinical Pediatric Surgery,,19():1088-1093,1112.[doi:10.3969/j.issn.1671-6353.2020.12.006]
Application experiences of integral covering technique of Buck’s fascia plus glans wings during tubularized incised plate urethroplasty for restoring normal penile anatomy of hypospadias
- CLC:
- R726.9;R697+.11;R695
- Abstract:
- Objective To explore the practicability and efficacy of integral coverage technique of Buck’s fascia plus glans wings for restoring anatomical penile structure during tubularized incised plate (TIP) urethroplasty for children with hypospadias.Methods From January 2018 to August 2020,128 cases of primary hypospadias underwent TIP urethroplasty were retrospectively analyzed.They were divided into two groups of A (n=77) and B (n=51) according to different covering methods.Group A underwent modified one-stage TIP urethroplasty with a new coverage technique of Buck’s fascia plus glans wings for restoring anatomical structure of penis.And group B underwent a conventional TIP procedure with a covering of superficial (dartos) fascia of foreskin.The perioperative clinical data and postoperative follow-up data of two groups were recorded and the results statistically analyzed.Results All operations were successful.No inter-group statistically significant difference existed in equilibrium test,such as age,position of urethral opening,penile length,average height/width of penile head,average width of urethral plate,curvature degree,number of cases of dorsal plication,average length of urethroplasty or average operative duration (P>0.05).During an average period of 16.5(3-32) months,they were followed up by telephones,emails,face-to-face consultations and online tools.Significant inter-group differences existed in the total number of postoperative complications,incidence of urinary and coronal fistulas.The postoperative complications of groups A and B were (n=9,11.6%) and (n=13,25.4%) respectively, there was significant inter-group difference (P=0.04).The urethral fistula of groups A and B were (n=5,6.5%) and (n=9,17.6%), including coronal fistulas (n=3,3.9%) and (n=7,13.7%) respectively, there was significant inter-group difference existed (P=0.04).In groups A and B,there were urethral stricture (n=2,2.6%)/(n=1,2%) and (n=2,2.6%)/(n=3,5.9%) of urethral dehiscence respectively.There was no significant inter-group difference (P>0.05).Conclusion Modified TIP procedure of integral coverage technique of Buck’s fascia plus glans wings is safe,practical and effective for repairing hypospadias in children.It can restore anatomic structure of penis and reduce the incidence of urinary fistula,especially coronal fistula.
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Memo
收稿日期:2020-09-26。
基金项目:安徽省卫生健康委员会科研计划项目（编号：2019SEY006）；安徽省儿童医院院级课题（编号：2018112）；安徽省儿童医院重点专科项目（编号：20186212）
通讯作者:潮敏,Email:cm0654@sina.com