收稿日期:2016 — 11 — 29)
目的 分析重度尿道下裂多次手术皮肤缺损患儿采用口腔黏膜镶嵌式尿道成形阴囊中缝带蒂皮瓣转移覆盖术的治疗效果。 方法 收集2013年10月至2016年10月间入住本院的16例尿道下裂手术治疗失败需再次手术病例,年龄4～13岁,平均年龄7.5岁。尿道重塑均采用口腔黏膜镶嵌尿道成形术,再游离阴囊中缝带蒂皮瓣将之转移至阴茎腹侧创区皮肤缺损处,均顺利完成手术。 结果 16例患儿术后均通过电话预约门诊复查完成随访,随访时间12～24个月,平均随访时间为15个月。患儿阴囊中缝转移皮瓣均成活,排尿顺畅,尿道外口位置良好,无尿道憩室和尿道瘘发生,阴茎阴囊外观患儿家长满意。 结论 多次进行手术修补失败的尿道下裂患儿采用口腔黏膜镶嵌尿道成形术重塑尿道后联合阴囊中缝带蒂皮瓣转移覆盖术治疗,术后患儿阴茎阴囊外观满意,无尿道憩室尿道瘘发生,疗效满意,治愈率高,值得临床推广应用。
Objective To explore the clinical efficacy of mid-serotal fasciocutaneous flap for skin defect after multiple operations of hypospadias repair. Methods From October 2013 to October 2016,16 previously failed surgical cases of hypospadias were recruited. The mean age was 7.5(4-13)years. Mid-scrotal fasciocutaneous flap was liberated with a vascular fascia pedicle and transferred to vacancy in ventral penis. Results During a mean follow-up period of 15(12-24)months,outpatient re-examinations were performed through telephone appointments. All flaps survived without urethral fistula or stricture. Voiding was smooth. All parents were satisfied with penile bending,urethral opening,penile appearance and scrotum. Conclusion s Mid-serotal fasciocutaneous flap is efficacious for skin defect after multiple operations of hypospadias repair. It is worth wider clinical popularization.
