Pediatric surgery international · 2012
Chronic urogenital sinus expansion in reconstruction of high persistent cloaca.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liu Xiang-Yang, Li Hong-Tao, Li Long, Chen Lei, Wang Li-Jie, Ma Kun, Zhao Bei-Bei, Hou Xing-Hong
Аннотация
OBJECTIVE: Soft tissue expansion is a technique useful in reconstruction when a shortage of tissue exists. This study presents an investigation on using chronic balloon expansion in the urethral and vaginal reconstruction of high persistent cloaca.
METHODS: The common channel was expanded by a balloon, which was progressively inflated over 3-4 weeks at a pressure of 30-50 mmHg until an adequate amount of tissue was obtained. The expanded channel was longitudinally split into anterior and posterior segments: the former was approximated to form a neourethra in continuity with the reconstructed bladder neck and the latter was tubularized to form a vagina.
RESULTS: Twenty-one patients underwent primary posterior sagittal urethro-vaginoplasty using the expanded urogenital sinus. Histologic examination demonstrated that the expanded tissue consisted of a dense fibrous wall lined with a stratified squamous non-cornified epithelium, which was characterized by active cell mitosis and angiogenesis. The patients were followed-up for 0.6-9 year (mean 5.69 ± 2.43 years). All reconstructed urethras, vaginas, and vulvas were satisfactory in color, texture match, and sensation. Urinary continence (grades I and II) was observed in all patients without intermittent catheterization. Two complications were encountered in our study. One patient showed a distal urethral dehiscence and a secondary urethroplasty was performed 6 months after the operation. Another patient developed a redundant urethra upon reaching puberty and urethroplasty was needed.
CONCLUSION: Chronic balloon expansion allows the formation of adequate tissue similar in appearance and type to the vagina and urethra. It also provides a valuable surgical alternative for the management of high persistent cloaca.
METHODS: The common channel was expanded by a balloon, which was progressively inflated over 3-4 weeks at a pressure of 30-50 mmHg until an adequate amount of tissue was obtained. The expanded channel was longitudinally split into anterior and posterior segments: the former was approximated to form a neourethra in continuity with the reconstructed bladder neck and the latter was tubularized to form a vagina.
RESULTS: Twenty-one patients underwent primary posterior sagittal urethro-vaginoplasty using the expanded urogenital sinus. Histologic examination demonstrated that the expanded tissue consisted of a dense fibrous wall lined with a stratified squamous non-cornified epithelium, which was characterized by active cell mitosis and angiogenesis. The patients were followed-up for 0.6-9 year (mean 5.69 ± 2.43 years). All reconstructed urethras, vaginas, and vulvas were satisfactory in color, texture match, and sensation. Urinary continence (grades I and II) was observed in all patients without intermittent catheterization. Two complications were encountered in our study. One patient showed a distal urethral dehiscence and a secondary urethroplasty was performed 6 months after the operation. Another patient developed a redundant urethra upon reaching puberty and urethroplasty was needed.
CONCLUSION: Chronic balloon expansion allows the formation of adequate tissue similar in appearance and type to the vagina and urethra. It also provides a valuable surgical alternative for the management of high persistent cloaca.