Triangular extension of hinge flaps: A novel technique to resolve stomal stenosis and prevent restenosis in staged buccal mucosal urethroplasty
Triangular extension of hinge flaps: A novel technique to resolve stomal stenosis and prevent restenosis in staged buccal mucosal urethroplasty
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铰链瓣三角延伸：分期颊粘膜尿道成形术中解决造口狭窄和预防再狭窄的新技术
DOI：
10.1111/iju.14582
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发表时间：
2021
影响因子：
2.6
通讯作者：
Kiyosawa Tomoharu
中科院分区：
文献类型：
--
作者：
Azuma Ryuichi;Horiguchi Akio;Ojima Kenichiro;Shinchi Masayuki;Aizawa Tetsushi;Tsuchiya Masato;Nakayama Eiko;Nagano Hisato;Ito Keiichi;Asano Tomohiko;Kiyosawa Tomoharu
ObjectivesTo验证颊粘膜分期尿道成形术中铰链瓣三角形延伸的实用性，以解决第一阶段后吻合口狭窄并最终防止再狭窄。在第一阶段，颊粘膜移植，并延长三角形部分的粘膜被放置在近端和/或远端造口，当尿道狭窄段被切除时创建。在第二阶段，在尿道板的管状化过程中，在造口处做一个切口，以增加插入三角形延伸部的口径。在第二期尿道成形术后6个月时，17 Fr柔性膀胱镜通过重建尿道时，认为手术成功，无需额外手术或探条扩张。将三角形延伸组的临床过程与24例接受传统分期尿道成形术（对照组）的患者进行比较。三角形延长段组中没有患者因为一期手术后吻合口狭窄而需要额外的翻修手术，而对照组中有5例（20%）患者需要。三角延伸组有19名患者（95%）成功进行尿道成形术，对照组有19名患者（95%）成功进行尿道成形术。第二阶段手术后的尿流率表明，三角形延伸和对照程序后的平均最大尿流率分别为21.5和15.8 mL/s（P = 0.027）。
ObjectivesTo verify the utility of triangular extension of a hinge flap in buccal mucosal staged urethroplasty to resolve stomal stenosis after the first stage and ultimately prevent restenosis.MethodsA total of 23 patients (triangular extension group) were studied in 2013–2019. In the first stage, buccal mucosa was transplanted, and an extended triangle portion of the mucosa was placed beside the proximal and/or distal stoma that was created when the stricture segment of the urethra was resected. In the second stage, during tubularization of the urethral plate, an incision was made at the stoma to increase the caliber to which the triangular extension was inserted. The procedure was considered successful when a 17‐Fr flexible cystoscope passed through the reconstructed urethra at 6 months after the second‐stage urethroplasty and no additional surgery or bougie dilation required. The clinical course of the triangular extension group was compared with 24 patients who underwent conventional staged urethroplasty (control group).ResultsIn total, 20 patients from each group underwent second‐stage surgery. No patients in the triangular extension group required additional revision surgery because of stomal stenosis after first‐stage surgery, whereas five (20%) control patients did. Urethroplasty was successful in 19 patients (95%) in the triangular extension group and in 19 patients (95%) in the control group. Uroflowmetry after the second‐stage surgery indicated that the mean maximum urinary flow rate was 21.5 and 15.8 mL/s after triangular extension and the control procedure, respectively (P= 0.027).ConclusionsThe triangular extension technique reduces the need for revision surgery and prevents postoperative restenosis.
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影响因子：
2
作者：
Mori RL;Angermeier KW
通讯作者：
Angermeier KW
影响因子：
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Dubey, D;Sehgal, A;Kumar, A
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Kumar, A
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