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中華民國泌尿科醫學會雜誌

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篇名 One-Stage Hypospadias Repair-Experience of 31 Patients
卷期 3:3
並列篇名 尿道下裂單次重建手術-31例經驗
作者 余燦榮
頁次 848-854
關鍵字 hypospadiasurethroplastychordeefistulaTSCI
出刊日期 199209

中文摘要

尿道下裂的手術是一項具有挑戰性的泌尿生殖重建手術。從1990年8月到1991年12月總共有31位,平均年齡3歲半的病人接受尿道下裂單次尿道形成手術。手術後發生陰莖腹側皮瓣壞死的有一例,其傷口經自然癒合後並沒有形成尿道皮膚瘻管。有一例尿道口狹窄而接受尿道口切開術。另有兩例為尿道皮膚瘻管須接受第二次的瘻管縫合術手術。所有的病人皆利用整形手術的器械及縫合材料,手術的部位再放大三倍半下來完成。有十三例前尿道下裂的病人可經由門診手術來完成,其中九例不需要尿道瘻管,十八例接受包皮橫位島狀皮管尿道形成術的病人則住院治療。住院中對仍包尿布的小孩,手術後利用兩片尿布的方法維持傷口的乾躁。在能控制解尿的病人則放置恥骨上方膀胱引流管及利用柔軟矽質短管置於新成型的尿道。於拔除恥骨上方膀胱引流管後讓病人間歇自解小便,以減少因尿液的滯留而發生傷口感染的機會。一次尿道成形手術可以利用沒有瘢痕的組織而且龜頭的整形效果較佳,且新的尿道開口也能置於陰莖前端,對於能遵守及了解尿道下裂治療定律的醫師,它可以適用於任何種類的尿道下裂且效果良好。

英文摘要

Form August 1990 to December 1991 a total of 31, one-stage urethroplasty for primary hypospadias was performed. The method of the operation and the classifica-tion of the hyospadias depended on the new location of the meatus after correction of the associated chordee. The patients presented with anterior hypospadias without chordee were treated respectively by meatal advancement and glanuloplasty (MAGPI) or by Mathieu flip-flap and onlay island flap. Both of the patients presented with an-terior hypospadias associated with chordee and the patients with posterior hypospadias were managed by transverse vascular pedicle skin tube. All the 31 patients have been followed for 3 months at least, including 11 patients for one year, 17 patients for 6 months and 3 patients for 3 months. The mean followp duration was 8 months. There were 4 postoperative complicaitons, including one skin flap necrosis, one meatal stenosis and two fistulae. No loss of neourethra was detected in all of the patients.

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