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Closure of urethral fistulae using a de-epithelialized skin advancement flap
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PEDIATRIC SURGERY
- Issue:
- 12
- DOI:
- 10.3760/cma.j.issn.0253-3006.2007.12.006
- Key Word:
- 尿瘘;尿道下裂;修补手术,外科
Abstract： 目的 总结去上皮推进皮瓣法修补尿道下裂术后各类尿瘘的经验.方法 采用去上皮推进皮瓣法治疗尿道下裂术后各类尿瘘62例,其中位于冠状沟9例,阴茎体48例,阴囊5例.37例尿瘘直径大于0.5 cm.主要步骤为游离瘘管至颈部并切除,皮内连续内翻缝合关闭瘘口,切除2～3 mm近端侧上皮(冠状沟尿瘘)或瘘口一侧上皮(阴茎体和阴囊部尿瘘),形成带血管蒂皮下组织瓣并推进覆盖瘘口,然后对侧全厚皮瓣覆盖去上皮组织瓣,形成交错缝合.如尿瘘双侧皮肤都较丰富,可作双侧带蒂皮下组织瓣,并交叉覆盖.术后不作尿流改道及留置导尿管.结果 手术一次成功率为95.2%(59/62),冠状沟尿瘘成功率为88.9%(8/9),阴茎体为95.8%(46/48),阴囊为100%.3例修补失败者在术后6个月～1年再次采用去上皮推进带蒂皮瓣法治疗后治愈.37例直径大于0.5 cm尿瘘成功率为94.6%.结论 去上皮推进皮瓣法是治疗各类尿瘘的一种较佳方法.
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