Clinical application of Duckett technique combined with scrotum mediastinal duct urethroplasty in severe pediatric hypospadias
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摘要: 目的 研究Duckett术联合阴囊纵隔皮管成形术治疗重度尿道下裂的疗效。方法 回顾性分析2016年1月—2022年1月在长江大学附属荆州医院接受首次尿道成形术的重度尿道下裂(阴囊型和会阴型尿道下裂)27例患儿的临床资料。所有患儿平均年龄(5.3±2.3)岁；其中阴囊型23例，会阴型4例；合并显著阴茎下曲22例；阴茎伸直后尿道缺损平均长度(6.2±0.9) cm。结果 所有患儿平均手术时间为(99.2±8.2) min；一次性成功达22例(81.4%)，其中23例阴囊型一次性成功有20例，4例会阴型一次性成功有2例；有5例术后1个月内发生尿瘘，半年后再次手术治愈。结论 Duckett术联合阴囊纵隔皮管成形术对于重度尿道下裂患儿治疗效果良好，无需分期手术，同时尿瘘和尿道狭窄并发症较低，外观令人满意。Abstract: Objective To study the effect of Duckett technique combined with scrotum mediastinal duct urethroplasty in the treatment of severe pediatric hypospadias.Methods Clinical data of 27 children with severe hypospadias (scrotal and perineal hypospadias) who received first urethroplasty in Jingzhou Hospital Affiliated to Yangtze University from January 2016 to January 2022 were retrospectively analyzed. The mean age of all patients was (5.3±2.3) years, including 23 cases of scrotal type and 4 cases of perineal type, 22 cases with significant penile flexion. The mean length of urethral defect after straightening the penis was (6.2±0.9) cm.Results The mean operation time of all children was (99.2±8.2) min. The first-attempt operation of 22 cases were successful (81.4%) including 20 cases of scrotal type and 2 cases of perineal type. Urinary fistula occurred in 5 cases within 1 month after operation, but they were cured by reoperation six months later.Conclusion Duckett technique combined with scrotum mediastinal duct urethroplasty is effective in the treatment of severe pediatric hypospadias without staging operation. The rate of complications of urinary fistula and urethral stricture are low, and the postoperative appearance is satisfactory.
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