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　　国外泌尿科专家对肖传国两年来在美国做的几个手术效果的评价

　　作者：gadfly 

　　要点：

　　1. 对脊椎损伤(Spinal Cord Injury)病人该手术到目前为止“无效”；
　　2. 对成年病人也没见到效果；
　　3. 主要的手术并发症是脚软弱（foot weakness）. 有小孩因此产生了“垂
足（foot drop）”；
　　4. 在手术达到类似“肖医生所声称的在中国87％成功率”之前，强调对该手
术要谨慎(emphasize caution)。

　　（九名接受手术的先天性脊柱裂小孩中有一名小孩恢复正常排尿控制。研究
表明，先天性脊柱裂一旦发生尿失禁，有12％的患者会恢复正常。）

　　Urology chairman called the results at Beaumont "mixed"

　　Chuan-Guo Xiao, a urologist from China, has performed the surgery 
on about 1,500 children and adults in China who are paralyzed by 
spinal cord injuries or suffer from spina bifida.

　　Xiao claims an 87 percent success rate.

　　The Xiao procedure was made a pilot study two years ago at the 
William Beaumont Hospital in Royal Oak, Mich. Surgeons performed the 
Xiao on nine kids with spina bifida and three with spinal cord injuries. 
Funds were raised to cover the cost of each surgery — between $40,000 
and $50,000. The team was led by the hospital's urology chairman, 
Kenneth Peters, who had traveled to China.

　　Peters, Xiao and the All Children's surgeons will speak at the 
First World Conference on Spina Bifida Research this week in Orlando.

　　By telephone last week, Peters called the results of the pilot at 
Beaumont "mixed."

　　Twelve children got the surgery — three with spinal cord injuries, 
nine with spina bifida. The three with spinal cord injuries were not 
helped by the procedure. Seven of the nine with spina bifida saw 
"marked improvement." One of them was a "home run," a girl who 
achieved complete continence.

　　Peters said the major complication was leg weakness that developed 
among eight of the nine with spina bifida. All had been able to walk 
before the surgery. They often required intense physical therapy, 
Peters said, "just to get them back to baseline." One child developed 
drop foot, meaning he could not raise his foot when he walked.

　　"We knew there could be complications going in," he said, "but it 
was still frustrating."

　　When Peters addresses the conference this week, he will emphasize 
caution. Parents are desperate for help, he said. But because of the 
unknowns, "if a parent walked into my office and stuck $50,000 in my 
face, I'd have to say no."

　　The surgeries should continue, he said, only under the strictest 
research protocol until U.S. doctors see the kind of results that Xiao 
reports in China. Beaumont will perform four more Xiao procedures in 
May.

　　Peters: "Do the benefits outweigh the risks? I'm not ready to say 
that. It's very easy to be wowed by it. I was wowed in China when I 
saw Dr. Xiao's data. I'm still wowed, but my 'wow' is a little more 
tempered."

(XYS20090813)

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