Combined Dorsal Plus Ventral Double-Graft Urethroplasty in Anterior Urethral Reconstruction
Combined Dorsal Plus Ventral Double-Graft Urethroplasty in Anterior Urethral Reconstruction
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DOI：
10.1007/s12262-014-1106-6
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发表时间：
2015-12-01
影响因子：
0.4
通讯作者：
Wang, Kunjie
中科院分区：
文献类型：
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作者：
Jiang, Jianchun;Zhu, Yuchun;Wang, Kunjie
本研究旨在探讨背侧联合腹侧双移植尿道成形术在前尿道重建中的效果。对2005年至2010年在华西医院接受移植尿道成形术治疗前尿道狭窄的患者进行随访并进行临床评估。根据移植物固定的部位，将患者分为单嵌体组（背侧或腹侧）和双嵌体组（背侧+腹侧）。比较两组的成功率和并发症，并采用t检验和卡方进行分析。共有77例患者完成随访，其中单组51例，双组26例。两组在年龄、长度、部位、狭窄原因、所用移植物类型等方面均无统计学差异。双组平均随访时间为15.6个月（4至33个月），单组为39.5个月（15至59个月）。单镶组总成功率为72.5%，双镶组总成功率为88.5%；不存在统计学差异（p>0.05）。亚组分析显示，双尿道成形术治疗阴茎阴囊交界部狭窄的成功率较高（88.9% vs 60.9%，p0.05）。背侧加腹侧联合双移植物尿道成形术对于前尿道狭窄，尤其是阴茎阴囊交界处的狭窄，具有较高的成功率和较低的并发症发生率。
This study aims to investigate the effect of combined dorsal plus ventral double-graft urethroplasty in anterior urethral reconstruction. Patients who underwent graft urethroplasty for anterior urethral strictures at West China Hospital from 2005 to 2010 were followed up with clinical evaluation. According to the site of graft fixed, patients were divided into single-onlay group (dorsal or ventral) and double-onlay group (dorsal plus ventral). Success rate and complications were compared between the two groups and were analyzed using t test and chi-square. A total of 77 patients completed the follow-up, 51 in single-onlay group and 26 in double group. There was no statistical difference in terms of age, length, site, stricture reason, and the type of graft used between the two groups. The mean follow-up time was 15.6 months (range from 4 to 33 months) in double group and 39.5 months (range from 15 to 59 months) in single group. The total success rate was 72.5 % in single-onlay group and 88.5 % in double-onlay group; no statistical difference existed (p>0.05). Subgroup analysis shows the success rate was higher for double-onlay urethroplasty for the stricture of penoscrotal junction (88.9 vs 60.9 %, p0.05). Combined dorsal plus ventral double-graft urethroplasty showed a high success and low complication rate for anterior urethral strictures, especially for the penoscrotal junction.