TFP与TIP在青少年远段型尿道下裂首次修复中的疗效对比

李忠远; 郭永连; 李国灏; 陈琳; 万志华; 应诚诚; 朱建宁; 陈瑞宝

doi:10.13201/j.issn.1001-1420.2020.12.007

TFP与TIP在青少年远段型尿道下裂首次修复中的疗效对比

- 1. 华中科技大学同济医学院附属武汉中心医院泌尿外科(武汉, 430014);
- 2. 华中科技大学同济医学院附属同济医院泌尿外科

详细信息

通讯作者: 郭永连,E-mail:1538088146@qq.com

中图分类号: R693

收稿日期: 2019-12-12

Turnover flap procedure for primary distal hypospadias repair in adolescents: comparison with the TIP

- 1. Department of Urology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China;
- 2. Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

More Information

Corresponding author: GUO Yonglian, E-mail: 1538088146@qq.com

Received Date: 12 December 2019

摘要

摘要: 目的:比较皮瓣翻转尿道成形术(turnover flaps procedure,TFP)与尿道板纵切卷管成形术(tubularized incised plate,TIP)在首次修复青少年远段型尿道下裂中的疗效。方法:回顾性分析2008年7月~2018年12月我院收治的42例青少年远段型尿道下裂患者首次手术修复情况,将其分为TIP组(n=27)和TFP组(n=15),观察其治疗效果。结果:两组患者临床特征、手术成功率、阴茎头外观满意度、围术期疗效差异无统计学意义;术后并发症(伤口裂开、尿道皮肤瘘、尿道口狭窄)TFP组(1/15,6.7%)、TIP组(12/27,44.4%),尿道口狭窄发生率TFP组(0/15,0)、TIP组(7/27,25.9%),差异均有统计学意义(P＜0.05);术后最大尿流率TFP组高于TIP组(P=0.029),差异有统计学意义。结论:与TIP相比,TFP术后并发症少,尿道口狭窄发生率低,TFP可作为青少年远段型尿道下裂首次修复的首选术式。
- 尿道下裂 /
- 青少年 /
- 皮瓣翻转尿道成形术 /
- 尿道板纵切卷管成形术
Abstract: Objective: To compare the outcome of surgery between the turnover flap(TFP) procedure and the tubularized incised plate(TIP) procedure in primary distal hypospadias repair in adolescents. Method: Between July 2008 and December 2018, a total of 42 adolescents underwent primary distal hypospadias repair with either the TIP procedure(n=27) or the TFP procedure(n=15). Patients' demographics, perioperative outcomes, complications, and postoperative uroflowmetry in each surgical group were analyzed retrospectively. Result: The patients' demographics, primary success rate, glans appearance and perioperative outcomes were similar in the two groups. The number of patients with at least one complication, including wound dehiscence, urethrocutaneous fistula and urethral stricture, was lower in the TFP group(1/15, 6.7%) than in the TIP group(12/27, 44.4%, P=0.011). The incidence of urethral stricture was lower in the TFP group(0/15, 0) than in the TIP group(7/27, 25.9%, P=0.031). In postoperative uroflowmetry, the peak flow of the TFP group was higher(P=0.029).Conclusion: The TFP procedure is clinically useful in primary repairing adolescent distal hypospadias because it offers lower complication rate.
- hypospadias /
- adolescent /
- turnover flap procedure /
- tubularized incised plate

HTML全文

参考文献(15)

[1]	Mammo TN,Negash SA,Negussie T,et al.Hypospadias Repair in Ethiopia:A Five Year Review[J].Ethiop J Health Sci.2018,28(6):735-740.
[2]	van der Horst HJ,de Wall LL.Hypospadias,all there is to know[J].Eur J Pediatr.2017,176(4):435-441.
[3]	Rynja SP,de Jong TPVM,Bosch JLHR,et al.Proximal hypospadias treated with a transverse preputial island tube:long-term functional,sexual,and cosmetic outcomes[J].BJU Int.2018,122(3):463-471.
[4]	陈毅夫,祖建成,田稳,等.尿道板纵切卷管尿道成形术和包皮内板岛状皮瓣加盖尿道成形术治疗尿道下裂的临床疗效[J].临床泌尿外科杂志,2016,31(4):364-366.
[5]	Bush NC,Snodgrass W.Pre-incision urethral plate width does not impact short-term Tubularized Incised Plate urethroplasty outcomes[J].J Pediatr Urol,2017,13(6):625.e1-625.e6.
[6]	Khalil M,Gharib T,El-Shaer W,et al.Mathieu technique with incision of the urethral plate versus standard tubularised incised-plate urethroplasty in primary repair of distal hypospadias:A prospective randomised study[J].Arab J Urol,2017,15(3):242-247.
[7]	Snodgrass W,Bush N.Is distal hypospadias repair mostly a cosmetic operation?[J].J Pediatr Urol,2018,14(4):339-340.
[8]	Snodgrass W,Bush NC.Re-operative urethroplasty after failed hypospadias repair:how prior surgery impacts risk for additional complications[J].J Pediatr Urol,2017,13(3):289.e1-289.e6.
[9]	Oztorun K,Bagbanci S,Dadali M,et al.A retrospective analysis of mathieu and tip urethroplasty techniques for distal hypospadias repair;a 20 year experience[J].Arch Esp Urol,2017,70(7):679-687.
[10]	Alshafei A,Cascio S,Boland F,et al.Comparing the outcomes of tubularized incised plate urethroplasty and dorsal inlay graft urethroplasty in children with hypospadias:a systematic review and meta-analysis[J].J Pediatr Urol,2020,16(2):154-161.
[11]	Winberg H,Anderberg M,Arnbjörnsson E,et al.Tubularized incised plate(TIP)repair improves outcome of hypospadias repair[J].J Surg,2016,4:1-4.
[12]	Duan S,Jiang X,Zhang X,et al.Megameatus intact prepuce treated with urethral plate-preserving surgery:a retrospective study of an unusual hypospadias variant[J].Transl Androl Urol,2019,8(6):583-590.
[13]	Turkyilmaz Z,Karabulut R,Atan A,et al.Redo Hypospadias Repair:Comparison of Three Different Methods[J].Urol Int,2020,104(5-6):391-395..
[14]	Aguilera-Pujabet M,Gander R,Royo GF,et al.Is the Mathieu urethroplasty a useful technique for urethrocutaneous fistula repair after hypospadias surgery?[J].Cir Pediatr,2018,31(4):176-181.
[15]	Winberg H,Arnbjörnsson E,Anderberg M,et al.Postoperative outcomes in distal hypospadias:a meta-analysis of the Mathieu and tubularized incised plate repair methods for development of urethrocutaneous fistula and urethral stricture[J].Pediatr Surg Int,2019,35(11):1301-1308.