Fan Xu,Yang Yi..Comparative study of postoperative complications for different tissues during hypospadias surgery[J].Journal of Clinical Pediatric Surgery,,17():571-576.
Comparative study of postoperative complications for different tissues during hypospadias surgery
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第17卷
Number:
2018 08
Page:
571-576
Column:
专题讨论
Date of publication:
2018-08-28
- Keywords:
- Hypospadias; Urinary Fistula; Surgical Flaps; Reoperation; Comparative Study
- Document code:
- A
- Abstract:
- ObjectiveTo compare the differences of complication rates with additional coverage and select the optimal urethral covering material during hypospadias surgery.MethodsA retrospective study was conducted for 150 patients with hypospadics undergoing surgical repair from January 2014 to December 2016.They were divided into additional coverage (n=90) and uncovered (n=60) groups.According to intraoperative exploration of urethral orifice position,they were divided into proximal (n=115) and distal (n=35) hypospadias groups.And the additional coverage group was divided into tunica vaginalis (n=30),dartos flap (n=42) and midscrotalfasciocutaneous flap (n=18) groups.ResultsNo statistical difference existed in median age,mean glans diameter,penile traction length,penile curvature degree or urethral defect length between additional coverage and uncovered groups.And 35/150 cases had postoperative complications with a complication rate of 23.33%.The complication rate was 13.33% in additional coverage group and 38.33% in uncovered group.There was intergroup statistical difference (χ2=12.578,P=0.001).While the incidence of urethral fistula rate was 8.89%（8/90） in additional coverage group and 33.33%（20/60） in uncovered group.There was intergroup statistical difference (χ2=19.036,P=0.001).Among 115 proximal hypospadics,79 cases used additional covering materials,10 (12.65%) had postoperative complications,36 cases used no additional covering materials and 16 cases (44.44%) had postoperative complications.There was intergroup statistical difference (χ2=14.28,P=0.01).While 7.59% of proximal hypospadics had postoperative urethral fistula with additional covering materials,36.1% of proximal hypospadics had postoperative urethral fistula without additional covering materials (χ2=14.58,P=0.01).The complication rate was 9.52% in dartos flap group,10% in tunica vaginalis flap group and 27.78% in midscrotal fasciocutaneous flap group.No statistical difference existed among three groups (χ2=4.07,P=0.13).Urethral fistula was 9.52% in dartos flap group,0.00% in tunica vaginalis flap group and 22.22% in midscrotal fasciocutaneous flap group.Statistical differences existed among three groups (χ2=6.90,P=0.03).ConclusionAdditional coverage may effectively reduce the complication rate of hypospadias.As compared with other cover tissues,tunica vaginalis effectively lower the incidence of postoperative urethral fistula.
Last Update:
2018-08-21