[1]任祯涛,张潍平.尿道下裂手术中覆盖材料的研究进展[J].临床小儿外科杂志,2022,21(01):30-35.[doi:10.3760/cma.j.cn.101785-202009034-006]
　Ren Zhentao,Zhang Weiping.Research progress of urethral coverage in hypospadias repair[J].Journal of Clinical Pediatric Surgery,2022,21(01):30-35.[doi:10.3760/cma.j.cn.101785-202009034-006]
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尿道下裂手术中覆盖材料的研究进展

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第21卷 期数: 2022年01期 页码: 30-35 栏目: 专题·先天性尿道下裂 出版日期: 2022-01-28
Title:
Research progress of urethral coverage in hypospadias repair
作者:
任祯涛1;  张潍平2
1 山西省儿童医院泌尿外科, 太原 030000;
2 国家儿童医学中心, 首都医科大学附属北京儿童医院泌尿外科, 北京 100045
Author(s):
Ren Zhentao1;  Zhang Weiping2
1 Department of Urology, Shanxi Children’s Hospital, Taiyuan City, Shanxi Province 030000;
2 National Children’s Medical Center, Department of Urology, Beijing Children’s Hospital Affiliated to Capital Medical University, Beijing 100045
关键词:
尿道下裂/外科学; 尿道皮肤瘘; 覆盖材料
Keywords:
Hypospadias/SU; Urethrocutaneous Fistula; Covering Materials
DOI:
10.3760/cma.j.cn.101785-202009034-006
摘要:
尿道下裂（hypospadias）是小儿泌尿生殖系统常见的先天性畸形之一，手术的目的是恢复尿道功能和外观的正常。目前已报道的手术方式达300种，但无论选择哪种术式，术后并发症的发生率均较高，其中最常见并发症是尿道皮肤瘘（urethrocutaneous fistula，UCF），发生率0%~35%不等。为减少术后并发症，降低UCF的发生率，目前广泛应用的方法之一是选择合适的覆盖材料作为成型尿道的"保护层"。覆盖材料主要分为自体材料与人工材料两大类。本文对尿道下裂手术中覆盖材料的研究进展进行综述。
Abstract:
Hypospadias is one of the most common congenital urinary malformations.There have been 300 different surgical methods for hypospadias repair, with its goal to achieve cosmetic and functional normality.Urethrocutaneous fistula (UCF) is the most common postoperative complication of hypospadias repair, its incidence may reach from 0 to 35%.The use of appropriate coverage layer in urethroplasty can reduce postoperative complications and prevent UCF in particular.Various techniques have been described for flap harvesting, including autogenic and artificial coverage.This paper reviews the research progress of urethral coverage in hypospadias repair based upon the published literature.

参考文献/References:

[1] van der Horst HJ,de Wall LL.Hypospadias,all there is to know[J].Eur J Pediatr,2017,176(4):435-441.DOI:10.1007/s00431-017-2864-5.
[2] Springer A,van den Heijkant M,Baumann S.Worldwide prevalence of hypospadias[J].J Pediatr Urol,2016,12(3):151-152.DOI:10.1016/j.jpurol.2015.12.002.
[3] Hardwicke JT,Bechar JA,Hodson J,et al.Fistula after single-stage primary hypospadias repair-A systematic review of the literature[J].J Plast Reconstr Aesthet Surg,2015,68(12):1647-1655.DOI:10.1016/j.bjps.2015.07.024.
[4] Agrawal K,Misra A.Unfavourable results in hypospadias[J].Indian J Plast Surg,2013,46(2):419.DOI:10.4103/0970-0358.118623.
[5] Jungwirth A,Giwercman A,Tournaye H,et al.European association of urology guidelines on male infertility:the 2012 update[J].European Urology,2012,62(2):324-332.DOI:10.1016/j.eururo.2012.04.048.
[6] Fahmy O,Khairul-Asri MG,Schwentner C,et al.Algorithm for optimal urethral coverage in hypospadias and fistula repair:a systematic review[J].Eur Urol,2016,70(2):293-298.DOI:10.1016/j.eururo.2015.12.047.
[7] 黄鲁刚,张潍平.尿道板纵切卷管尿道成形术的应用再思考[J].临床小儿外科杂志,2020,19(12):1061-1065.DOI:10.3969/j.issn.1671-6353.2020.12.001. Huang LG,Zhang WP.Some focal issues of applying tubularized incised plate for repairing hypospadias[J].J Clin Ped Sur,2020,19(12):1061-1065.DOI:10.3969/j.issn.1671-6353.2020.12.001.
[8] Safwat A,Al-Adl AM,El-Karamany T.Vascularized dartos flap in conjunction with tubularized incised plate urethroplasty:single versus double flaps for management of distal hypospadias[J].Curr Urol,2012,6(2):67-70.DOI:10.1159/000343511.
[9] Retik AB,Mandell J,Bauer SB,et al.Meatal based hypospadias repair with the use of a dorsal subcutaneous flap to prevent urethrocutaneous fistula[J].J Urol,1994,152(4):1229-1231.DOI:10.1016/s0022-5347(17)32555-7.
[10] Demir A,Karada? MA,?e?en K,et al.Our Experience with a double-layer surgical technique for preventing fistula development in children and young adults with hypospadias[J].Urol Int,2015,95(2):132-136.DOI:10.1159/000431103.
[11] Thomas DT,Karadeniz Cerit K,Yener S,et al.The effect of dorsal dartos flaps on complication rates in hypospadias repair:A randomised prospective study[J].J Pediatr Urol,2015,11(1):21-23.DOI:10.1016/j.jpurol.2014.07.010.
[12] Bertozzi M,Y?ld?z A,Kamal B,et al.Multicentric experience on double dartos flap protection in tubularized incised plate urethroplasty for distal and midpenile hypospadias[J].Pediatr Surg Int,2011,27(12):1331-1336.DOI:10.1007/s00383-011-2978-1.
[13] Snodgrass WT,Nguyen MT.Current technique of tubularized incised plate hypospadias repair[J].Urol,2002,60(1):157-162.DOI:10.1016/S0090-4295(02)01620-5.
[14] Sozubir S,Snodgrass W.A new algorithm for primary hypospadias repair based on tip urethroplasty[J].J Pediatr Surg,2003,38(8):1157-1161.DOI:10.1016/S0022-3468(03)00261-6.
[15] Djordjevic ML,Perovic SV,Slavkovic Z,et al.Longitudinal dorsal dartos flap for prevention of fistula after a snodgrass hypospadias procedure[J].Eur Urol,2006,50(1):53-57.DOI:10.1016/j.eururo.2006.04.014.
[16] Cimador M,Pensabene M,Sergio M,et al.Coverage of urethroplasty in pediatric hypospadias:Randomized comparison between different flaps[J].Int J Urol,2013,20(10):1000-10005.DOI:10.1111/iju.12092.
[17] Tam YH,Pang KKY,Wong YS,et al.Improved outcomes after technical modifications in tubularized incised plate urethroplasty for mid-shaft and proximal hypospadias[J].Pediatr Surg Int,2016,32(11):1087-1092.DOI:10.1007/s00383-016-3954-6.
[18] Motiwala HG.Dartos flap:an aid to urethral reconstruction[J].Br J Urol,1993,72(2):260-261.DOI:10.1111/j.1464-410x.1993.tb00710.x.
[19] Muruganandham K,Ansari MS,Dubey D,et al.Urethrocutaneous fistula after hypospadias repair:outcome of three types of closure techniques[J].Pediatr Surg Int,2010,26(3):305-308.DOI:10.1007/s00383-009-2490-z.
[20] Ross JH,Kay R.Use of a de-epithelialized local skin flap in hypospadias repairs accomplished by tubularization of the incised urethral plate[J].Urology,1997,50(1):110-112.DOI:10.1016/S0090-4295(97)00212-4.
[21] Baccala AJ,Ross J,Detore N,et al.Modified tubularized incised plate urethroplasty (Snodgrass) procedure for hypospadias repair[J].Urology,2005,66(6):1305-1306.DOI:10.1016/j.urology.2005.07.011.
[22] El-Kassaby A,Al-Kandari AM,Elzayat T,et al.Modified Tubularized Incised Plate Urethroplasty for Hypospadias Repair:A Long-Term Results of 764 Patients[J].Urology,2008,71(4):611-615.DOI:10.1016/j.urology.2007.11.121.
[23] Bhat A,Sabharwal K,Bhat M,et al.Outcome of tubularized incised plate urethroplasty with spongioplasty alone as additional tissue cover:A prospective study[J].Indian J Urol,2014,4(30):392-397.DOI:10.4103/0970-1591.134234.
[24] Hafez AT,Helmy T.Tubularized incised plate repair for penoscrotal hypospadias:role of surgeon’s experience[J].Urology,2012,79(2):425-427.DOI:10.1016/j.urology.2011.10.033.
[25] Bilici S,Sekmenli T,Gunes M,et al.Comparison of dartos flap and dartos flap plus spongioplasty to prevent the formation of fistulae in the snodgrass technique[J].Int Urol Nephrol,2011,43(4):943-948.DOI:10.1007/s11255-011-9943-8.
[26] Hayashi Y,Mizuno K,Moritoki Y,et al.Can Spongioplasty Prevent Fistula Formation and Correct Penile Curvature in TIP Urethroplasty for Hypospadias?[J].Urology,2013,81(6):1330-1335.DOI:10.1016/j.urology.2013.01.005.
[27] Hamid R,Baba AA,Shera A,et al.Tunica vaginalis flap following’Tubularised Incised Plate’urethroplasty to prevent urethrocutaneous fistulaa[J].Indian J Plast Surg,2019,48(2):187-191.DOI:10.4103/0970-0358.163059.
[28] Pescheloche P,Parmentier B,Hor T,et al.Tunica vaginalis flap for urethrocutaneous fistula repair after proximal and mid-shaft hypospadias surgery:A 12-year experience[J].J Pediatr Urol,2018,14(5):421.DOI:10.1016/j.jpurol.2018.03.026.
[29] Seo S,Ochi T,Yazaki Y,et al.Soft tissue interposition is effective for protecting the neourethra during hypospadias surgery and preventing postoperative urethrocutaneous fistula:a single surgeon’s experience of 243 cases[J].Pediatr Surg Int,2015,31(3):297-303.DOI:10.1007/s00383-015-3655-6.
[30] Baba AA,Wani SA,Bhat NA,et al.Buck’s fascia repair with glanuloplasty in hypospadias surgery:A simple approach with excellent outcome[J].J Pediatr Urol,2017,13(6):631-633.DOI:10.1016/j.jpurol.2017.06.015.
[31] 潮敏,张殷,蒋加斌,等.BUCK筋膜联合阴茎头两翼整体覆盖恢复尿道下裂阴茎解剖结构在尿道板纵切尿道卷管成形术中的应用效果[J].临床小儿外科杂志,2020,19(12):1088-10931112.DOI:10.3969/j.issn.1671-6353.2020.12.006. Chao M,Zhang Y,Jiang JB,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].J Clin Ped Sur,2020,19(12):1088-1093,1112.DOI:10.3969/j.issn.1671-6353.2020.12.006.
[32] Zhang S,Zhou C,Li F,et al.Scrotal-Septal Fasciocutaneous Flap Used as a Multifunctional Coverage for Prior Failed Hypospadias Repair[J].Urol Int,2016,96(3):255-259.DOI:10.1159/000444331.
[33] Grossklaus DJ,Shappell SB,Adams MC,et al.Small intestinal submucosa as a urethral coverage layer[J].J Urol,2001,166(2):636-639.DOI:10.1016/S0022-5347(05)66033-8.
[34] Casal-Beloy I,Somoza Argibay I,García González M,et al.Dermal regeneration sheet Integra?in management of recurrent Urethrocutaneous fistula after hypospadias surgery[J].J Pediatr Urol,2019,15(6):631-634.DOI:10.1016/j.jpurol.2019.10.002.
[35] Kinahan TJ,Johnson HW.Tisseel in hypospadias repair[J].Can J Surg,1992,35(1):75-77.DOI:10.1016/0022-3468(93)90298-y.
[36] Kajbafzadeh A,Abolghasemi H,Eshghi P,et al.Single-donor fibrin sealant for repair of urethrocutaneous fistulae following multiple hypospadias and epispadias repairs[J].J Pediatr Urol,2011,7(4):422-427.DOI:10.1016/j.jpurol.2010.06.004.
[37] Guinot A,Arnaud A,Azzis O,et al.Preliminary experience with the use of an autologous platelet-rich fibrin membrane for urethroplasty coverage in distal hypospadias surgery[J].J Pediatr Urol,2014,10(2):300-305.DOI:10.1016/j.jpurol.2013.09.026.
[38] Mahmoud AY,Gouda S,Gamaan I,et al.Autologous platelet-rich plasma covering urethroplasty versus dartos flap in distal hypospadias repair:A prospective randomized study[J].Int J Urol,2019,26(4):475-480.DOI:10.1111/iju.13912.
[39] Springer A,Subramaniam R.Preliminary Experience With the Use of Acellular Collagen Matrix in Redo Surgery for Urethrocutaneous Fistula[J].Urology,2012,80(5):1156-1160.DOI:10.1016/j.urology.2012.06.058.
[40] Lin D,Wang G,Song H,et al.Use of Acellular Dermal Matrix for Urethroplasty Coverage in Proximal Hypospadias Repair:a Pilot Study[J].Adv Ther,2020,37(4):1425-1435.DOI:10.1007/s12325-020-01254-9.

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备注/Memo

收稿日期:2020-09-18。
基金项目:北京市协同发展子课题（XTYB201832）
通讯作者:张潍平,Email:zhangwp59616406@126.com

更新日期/Last Update: 1900-01-01