组织瓣覆盖技术在尿道下裂手术及术后尿瘘修复中的应用

目的探讨组织瓣覆盖技术在尿道下裂手术及尿瘘修复手术的效果。方法1998年3月至2003年5月，73例尿道下裂手术及术后尿瘘修复手术中，采用5种组织瓣覆盖技术覆盖新尿道及尿瘘内口。尿道下裂组45例中采用带蒂背侧皮下组织瓣转移法27例，带蒂鞘膜瓣转移法3例，局部阴囊推进肉膜瓣法15例；尿瘘组28例中采用带蒂背侧皮下组织瓣转移法4例，局部X—V皮瓣法14例，局部U形组织瓣法10例。结果随访3～36个月，尿道下裂组45例术后3例出现尿瘘，尿瘘组28例均未再发尿瘘，成功率95．9％。结论尿道下裂手术及尿瘘修复手术中采用组织瓣多层覆盖技术，可提高手术成功率，降低术后尿瘘发生率。

The use and effect of subcutaneous flap and tunica vaginalis flap technique in hypospadias repair and hypospadias fistulas repair

Objective To investigate the use and effect of subcutaneous flap and tunica vaginalis flap in hypospadias repair and hypospadias fistulas repair. Methods A total of 73 cases of hypospadias and hypospadias fistulas following surgery were included.The new urethras or closed fistulas were wrapped with various types of subcutaneous flaps or tunica vaginalis flaps.In the 45 cases of hypospadias,dorsal dartos flap technique was used in 27,tunica vaginalis flap technique in 3,and adjoining pedicle advance dartos flap technique in 15.In the 28 cases of urethral fistulas,dorsal dartos flap technique was used in 4,X-V skin flap technique in 14,and adjoining U-shaped subcutaneous flap technique in 10. Results All the cases were followed up for 3 to 36 months.Of the 45 cases of hupospadias, fistulas occurred in 3.Of the 28 cases of urethral fistulas, no fistulas occurred.The success rate of operation was 95.9%. Conclusions The use of these techniques can reduce the incidence rate of urethrocutaneous fistulas in hypospadias repair and hypospadias fistulas repair.Based on our experience these techniques are the optimal repair for classical patients with hypospadias and hypospadias fistulas.