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《Journal of Applied Clinical Pediatrics》 2012-23
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Application of Fascial Flap Covering Technique in Hypospadias Repair

LUO Yi-ge,YANG Ti-quan,DONG Chun-qiang,LIU Qiang,CHEN Chao,WEI Ting(Department of Pediatric Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China)  
Objective To investigate the technique and feasibility of fascial flap covering technique of raw surface in hypospadias reparation. Methods Six hundred and three cases of hypospadias were collected in which urethroplasty was carried out.Their ages range was from 2 years to 18 years.The operations for 486 cases were the first time,and the other 117 cases were treated the second or many times.According to the deficits of hypospadias,different types of urethroplasty were chosen,such as Mathieu,Pedicle island flap,Snodgrass,Duckett,Duckett + Duplay,Duplay,Thiersch and Tunica mucosa vesicas mrinariae procedures.All cases were divided into 2 groups according to the time limit of treatment and the covering methods of urethral raw surface.Fascial flap group(360 cases):these new urethras were covered by difference fascial flaps(urethra′s progradated fascial flap,mentula revolved fascial flap,mentula De-epithelialized skin flap,scrotum vaso-axis fascial flap and free fascial flap) and then mentula raw surface was covered by transferring skin flap and suturing allotopia.Skin flap group(243 cases):skin flap was used for covering mentula raw surface directly.All cases were treated with the same sutures and urethra supporting mate-rials.Infection prophylaxis was given postoperatively and urethral catheters were removed 10-14 days later. Results In all the types of urethroplasty,the incidence rate of urinary fistula in the fascial flap group was lower than that in the skin flap group.Except the Duplay and Tunica mucosa vesicae urinariae procedures,there was statistical significance between the 2 groups(Pa0.05).In the fascial flap group,there were 37 cases with urinary fistula,and no severe complication occurred such as whole urethra breakdown,the overall urinary fistula rate was 10.3%.In the skin flap group,there were 77 cases with urinary fistula and 17 cases with whole urethra breakdown.The overall urinary fistula rate was 31.7%(P=0.000). Conclusions The Fascial flap covering techniques can be generally undertaken which provide a favourable tissue covering for new urethra and reduce the convenience of urethral fistula.Fascial flap covering techniques can provide a favorable,and reduce the accident of urinary fistula.Fascial flap techniques would be used as a routine procedure for raw surface covering in urethroplasty.
【CateGory Index】: R699
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