尿道下裂一期修复术后并发症的预防

Ximeng Chen, X. Liao, Hai-kun Wang, Hui-xu He
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摘要

目的总结预防尿道下裂修补术后主要并发症的经验。方法回顾性分析2005年5月~ 2010年8月我院收治的189例尿道下裂修补术的临床资料。结果单期手术治愈174例。所有病例随访4 ~ 36(18.5±5.5)个月,成年后阴茎发育正常,勃起功能正常。术后并发症15例,其中尿道瘘9例,尿道狭窄6例,经对症治疗均治愈或好转。结论术前预防抗生素治疗、合理的手术步骤、术中尿道上尿改道、皮瓣血供良好、改良包覆、术后管理和护理是提高单期尿道成形术成功率和减少瘘、狭窄发生率的必要措施。关键词:尿道下裂;重建外科手术;术后并发症
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Prevention of postoperative complications after single-stage hypospadias repair
Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing. Key words: Hypospadias; Reconstructive surgical procedures; Postoperative complications
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