To Compare The Efficacy Of Minimally Invasive Anatomical Needle And Traditional Electric Knife In One-stage Repair Of Hypospadias

BackgroundsHypospadias is a common congenital malformation in pediatric urology.The incidence varies by race and region,ranging from 3/1000 to 8/1000 in newborn boys.Surgery is the only treatment for the disease,and postoperative urethral fistula is the main complication.If the intraoperative trauma is large and the postoperative recovery is poor,the incision may not heal,resulting in urethral fistula.Minimally invasive dissecting needle is a new type of electrosurgical product,which uses high-frequency electricity to form arc discharge and current high temperature at the tip of the needle,so that the tissue can be rapidly dehydrated,decomposed and evaporated,and blood can be coagulated,so as to achieve the purpose of tissue cutting and blood coagulation.ObjectiveThe purpose of this study was to understand the tissue dissociation and injury of the minimally invasive anatomical needle during the operation,the recovery of the postoperative wound and the occurrence of postoperative urethral fistula after the application of minimally invasive anatomical needle in hypospadias.In order to understand the positive effect of minimally invasive dissection needle in hypospadias,whether it is worth promoting.MethodsA total of 179 children with middle hypospadias treated in our hospital from January2010 to July 2022 were selected.The patients were divided into minimally invasive anatomical needle group(group A,n=104)and traditional high-frequency electrosurgical group(group B,n=75)according to the application of electroknife during operation.The operation time,intraoperative blood loss,Length of stay,cost of stayand postoperative complications were compared between the two groups.Results:In the minimally invasive anatomical needle group,the operation time was(97.25±11.23)min,the intraoperative blood loss was(10.15±5.24)ml,and the hospitalization cost was(15500±1400)yuan.In the traditional electric knife group,the operation time was(121.35±12.42)min,the intraoperative blood loss was(20.07±4.22)ml,and the hospitalization cost was(13100±2000)yuan.The difference between the two groups was statistically significant(p<0.001).There was no significant difference in the length of hospital stay between the two groups(p>0.05).including 15 cases of urinary fistula,5 cases of urethral stricture and 3 cases of urethral diverticulum in the minimally invasive anatomical needle group.There were 20 cases of urinary fistula,10 cases of urethral stricture and 7 cases of urethral diverticulum in the traditional electric knife group.The difference in the incidence of postoperative complications between the two groups was statistically significant(P<0.05).Conclusion:The application of minimally invasive anatomical electrocautery in the primary repair of hypospadias with transverse preputial island flap has the advantages of short operation time,small injury,less intraoperative bleeding,and high postoperative cure rate.The disadvantage is that it increases the cost during hospitalization.