スエヨシ リヨウ
  末吉 亮
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Reinforcing the ventral penile shaft with pedicled fat/connective tissues before urethroplasty lowers the risk for post-urethroplasty complications in hypospadias.
掲載誌名 正式名:Journal of pediatric surgery
略  称:J Pediatr Surg
ISSNコード:15315037/00223468
掲載区分国外
巻・号・頁 51(12),pp.2021-2024
著者・共著者 Sueyoshi Ryo†, Seo Shogo, Ochi Takanori, Murakami Hiroshi, Yazaki Yuta, Takeda Masahiro, Nakamura Hiroki, Lane Geoffrey J, Yamataka Atsuyuki
発行年月 2016/12
概要 PURPOSE:CHARGE is our technique for reinforcing the ventral penile shaft with pedicled pericordal/scrotal fat, pedicled perimeatal connective tissue, or a combination of these at the time of initial hypospadias surgery. Such pedicled grafts "charge" poorly developed urethral plates and thin ventral foreskin prior to urethroplasty to improve compromised vascular perfusion that could prevent post-urethroplasty complications (post-UPC).METHODS:We reviewed post-UPC in 179 staged hypospadias repair patients (1997-2015). CHARGE, adopted routinely in 2010 was used in 39 patients (C-group), not indicated in 7 because ventral connective tissue was thick, and not used in 133 (NC-group). Initial hypospadias surgery included foreskin degloving with or without chordectomy, dorsal plication, tunica albuginea incision, or a combination of these.RESULTS:Subject demographics were similar. NC had significantly more post-UPC than C (25 versus 0; p<.01) comprising stenosis (n=14), fistula (n=7), diverticulum (n=2), and wound infection (n=2) that developed after a mean of 0.7±0.2years (range: 1day-2.8years). Extra time taken for CHARGE was less than 15minutes in all cases. Mean follow-up after urethroplasty (years) was significantly shorter in C (1.5±1.0 versus 5.7±3.8) (p<.01), but almost double the time taken to develop post-UPC.CONCLUSION:CHARGE would appear to prevent post-UPC.LEVEL OF EVIDENCE:Retrospective Comparative Study - Level III.
DOI 10.1016/j.jpedsurg.2016.09.031
PMID 27686484