Dorsal Buccal Mucosal Graft Urethroplasty for Anterior Urethral Stricture by Asopa Technique
Dorsal Buccal Mucosal Graft Urethroplasty for Anterior Urethral Stricture by Asopa Technique
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DOI：
10.1016/j.eururo.2008.06.002
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发表时间：
2009-07-01
期刊：
影响因子：
23.4
通讯作者：
Sriramoju, Vidyasagar
中科院分区：
文献类型：
--
作者：
Pisapati, V. L. N. Murthy;Paturi, Srimannarayana;Sriramoju, Vidyasagar
工作背景：颊粘膜移植物替代尿道成形术在治疗顽固性前尿道狭窄方面已成为一种流行的治疗方法，并取得了良好的效果。背侧和腹侧高嵌体技术均报告了良好的长期结果。Asopa报道了经腹侧矢状入路背侧放置BMG治疗长段前尿道狭窄的成功方法。目的：前瞻性评价经腹侧矢状入路背侧放置BMG尿道成形术治疗复发性前尿道狭窄的效果和优点（Asopa技术）。设计、设置和参与者：2002年12月至2007年12月，共有58名男性通过腹侧矢状尿道切开术入路接受背侧BMG尿道成形术治疗复发性尿道狭窄。45这些患者的随访期为12-60个月进行了前瞻性评价，结果进行了analysed.Intervention：尿道被分裂两次在该网站的disturture腹侧和背侧没有动员它从床上，颊粘膜移植物被固定在背侧尿道缺损。结果和局限性：总体结果良好（87%），平均随访期为42个月。7名患者发生轻微伤口感染，5名患者发生瘘管。随访12-60个月，6例复发（6：45，13%）。2例全尿道狭窄和4例球部或半球部狭窄患者复发，并通过光学尿道切开术和自扩张术进行治疗。中期结果与报告的尿道背侧切开术一样好，长期结果有待观察。需要更多的随机试验和荟萃分析，以建立这种技术作为一个程序的选择在future.Conclusions：腹侧矢状尿道切开术的方法是更容易执行比背侧尿道切开术的方法，有良好的效果，特别是在长的前尿道狭窄。(C)2008年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Background: Buccal mucosal graft (BMG) Substitution urethroplasty has become popular in the management of intractable anterior Urethral strictures with good results. Excellent long-term results have been reported by both dorsal and ventral onlay techniques. Asopa reported a Successful technique for dorsal placement of BMG in long anterior urethral strictures through a ventral sagittal approach.Objective: To evaluate prospectively the results and advantages of dorsal BMG urethroplasty for recurrent anterior urethral strictures by a ventral sagittal urethrotomy approach (Asopa technique).Design, setting, and participants: From December 2002 to December 2007, a total of 58 men underwent dorsal BMG urethroplasty by a ventral sagittal Urethrotomy approach for recurrent Urethral strictures. Forty-five of these patients with a follow-up period of 12-60 mo were prospectively evaluated, and the results were analysed.Intervention: The urethra was split twice at the site of the Stricture both ventrally and dorsally without mobilising it from its bed, and the buccal mucosal graft was secured in the dorsal urethral defect. The Urethra was then retubularised in one stage.Results and limitations: The overall results were good (87%), with a mean follow-up period of 42 mo. Seven patients developed minor wound infection, and five patients developed fistulae. There were six recurrences (6:45, 13%) during the follow-up period of 12-60 mo. Two patients with a panurethral stricture and four with bulbar or penobulbar strictures developed recurrences and were managed by optical urethrotomy and self-dilatation. The medium-term results were as good as those reported with the dorsal Urethrotomy approach.Long-term results from this and other series are awaited. More randomised trials and meta-analyses are needed to establish this technique as a procedure of choice in future.Conclusions: The ventral sagittal urethrotomy approach is easier to perform than the dorsal urethrotomy approach, has good results, and is especially useful in long anterior urethral strictures. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.