ABSTRACT
Background: Meatal advancement with glanduloplasty (MAGPI) has been in the recent years one of the most frequently surgical techniques used for the correction of distal hypospadias. Multiple modifications have been described to improve the results ofthis technique. In 2004 we presented the initial results of the New Modern MAGPI or DUAGPI (distal urethral advancement and glanduloplasty) as a surgical alternative to the original MAGPI. Objetive: The objective of the present study is to evaluate the applicability, safety and the cosmetic results obtained with this technique, as well as the long-term complications. Materials and Methods: Retrospective and descriptive study of patients with distal hypospadias, corrected using the DUAPI technique, between 2002 and 2018. Surgical technique: Initially, an artificial erection was performed, the absence of curvature in all patients is proven. A skin denudation was performed up to the base of the penis in those children with a bend greater than 30. Second, the distal urethral disconnection was performed at the posterior and lateral urethral level. A glandular triangular section is made to accommodate the distal urethra and to allow a conical appearance with a final glandular. Finally, the fixation of the distal urethral to the glandular tip and the anterior glandular closure is performed. We performed an annual follow-up of all patients. The analysis of all the variables collected during surgery and follow-up was done with SPSS 22 statistical package. Results: 90 patients meet inclusion criteria and were included in the study (32 glandular and 58 coronal). The mean surgical time was 47 minutes (Range: 37-71 minutes). The mean follow-up was 9.4 years (2.1-15 years). 2 patients had meatal stenosis after surgery, 4 mild glandular retraction, and 2 urethrocutaneous fistula. Six of the 8 patients with a complication were successfully reoperated (AU)
Introducción: El avance meatal con glanduloplastia (MAGPI) ha sido una de las técnicas quirúrgicas másutilizadas para la corrección de los hypospadias distales.Desde su descripción inicial, multiples modificaciones hansido descritas para mejorar los resultados de esta técnica.En 2004, nosotros presentamos los resultados iniciales delNew Modern MAGPI o DUAGPI (avance uretral distaly glanduloplastia) como alternativa quirúrgica al MAGPIoriginal, y la hemos utilizado durante los últimos 15 años.Objetivo: El objetivo del presente estudio es evaluar la aplicabilidad, seguridad y los resultados estéticosobtenidos con esta técnica, así como sus complicaciones alargo plazo.Material y Métodos: Estudio retrospectivo y descriptivo, de pacientes con hipospadias con meato a nivel distal, corregidos utilizando la técnica DUAGPI, entre 2002y 2018. Técnica quirúrgica: Inicialmente realizamos unaerección artificial. La ausencia de curvatura en todos lospacientes fue comprobada . Se realiza la denudación peneshasta la base en los penes con una curvatura mayor a 30º. Secundariamente, se realiza la disección de la uretra distal en sus caras laterales y dorsal . Una sección glandular triangular se realiza para acomodar la uretra distal, logrando además un aspecto cónico y natural del glande . Finalmente, se realiza la fijación de la uretra distal avanzaday el cierre glandular . Realizamos un seguimiento anualde los pacientes, evaluando las complicaciones y los resultados estéticos tras la cirugía. El análisis de las variablesrecolectadas fue realizado con el paquete estadístico SPSS22.Resultados: 90 pacientes fueron incluidos en el estudio (32 hipospadias glandulares y 58 coronales), conuna edad media en el momento de la cirugía de 23 meses(Rango: 15-54). La media de tiempo quirúrgico...(AU)
Subject(s)
Humans , Male , Adolescent , Young Adult , Adult , Middle Aged , Urologic Surgical Procedures, Male/methods , Hypospadias/surgery , Follow-Up Studies , Retrospective Studies , Treatment OutcomeABSTRACT
Las duplicaciones intestinales duodenales son entidades raras, principalmente se presentan en la primerao segunda porción, siendo prácticamente excepcionalsu localización a nivel piloroduodenal, con menos dediez casos descritos en la literatura.Presentamos el caso de una neonata que a las 48 horas de vida manifestó un cuadro de obstrucción intestinal alta que requirió realizar una laparotomía exploradora, observándose un quiste piloroduodenal, que fueresecado en la intervención.Se trata de una entidad congénita extremadamenterara, los signos y síntomas son un desafío y el objetivoquirúrgico debe ser la exéresis completa. Si la reseccióntotal origina compromiso de los órganos adyacentes, laexéresis parcial con mucosectomía es una alternativaválida para evitar las complicaciones de una cirugíamás agresiva.(AU)
Intestinal duplications located in the duodenum arerare conditions that generally affect the first or secondduodenal portion. It is extremely unusual for this condition to be located in the pyloroduodenal area, accounting for less than ten documented cases.This research presents a case of a female newbornwho showed on the second day of life signs of upperintestinal obstruction which required exploratory laparotomy. The surgery revealed a pyloroduodenal cystthat was successfully excised.This is an extremely rare congenital anomaly thatencompasses challenging symptoms and signs, and thepurpose of the surgery should be the complete resection of the lesion. If the complete excision endangersthe surrounding organs, partial resection through mucosectomy is a valid alternative to prevent the complications of more invasive surgery.(AU)
Subject(s)
Humans , Female , Infant, Newborn , Inpatients , Physical Examination , Cysts , Intestinal Obstruction/surgery , Laparotomy , Neonatology , General SurgeryABSTRACT
Intestinal duplications located in the duodenum are rare conditions that generally affect the first or second duodenal portion. It is extremely unusual for this condition to be located in the pyloroduodenal area, accounting for less than ten documented cases. This research presents a case of a female newborn who showed on the second day of life signs of upper intestinal obstruction which required exploratory laparotomy. The surgery revealed a pyloroduodenal cyst that was successfully excised. This is an extremely rare congenital anomaly that encompasses challenging symptoms and signs, and the purpose of the surgery should be the complete resection of the lesion. If the complete excision endangers the surrounding organs, partial resection through mucosectomy is a valid alternative to prevent the complications of more invasive surgery.
