三种阴茎再造术的比较
发表时间：2014-07-01 浏览次数：867次
冯隽，李养群，唐勇等.三种阴茎再造术的比较[J].中华整形外科杂志.2014, 30(3):179-182
阴茎再造术;外科皮瓣;阴茎假体植人
冯隽，李养群，唐勇，杨喆，赵穆欣，陈文，马宁，王维新，胡春梅
中国医学科学院整形外科医院整形二科,北京,100144
2014
179-182
知网
目的 总结3种阴茎再造方法的效果.方法 2000年9月至2012年12月,应用3种不同的方法进行阴茎再造48例,包括吻合血管游离肩胛皮瓣法、带蒂髂腹股沟皮瓣法和旋股外侧血管岛状股前外侧皮瓣法.设计皮瓣长约12.0～ 14.5 cm,宽10～ 12 cm,尿道周径为2～3 crn.结果 应用吻合血管游离肩胛皮瓣法21例,因皮瓣本身血供及受区血管异常失败3例,11例放置了硅胶银丝棒假体,3例出现假体外露;带蒂髂腹股沟皮瓣法21例,8例皮瓣出现血运障碍导致部分坏死,7例放置了硅胶银丝棒假体,3例出现假体外露;股前外侧皮瓣法6例,2例皮瓣缺血坏死及感染失败,此法均未放置假体.所有首次手术失败者改用其他方法修复,最终均成功完成阴茎再造.术后随访37例,随访时间为1～6年,平均2.5年,26例患者对外形满意,排尿功能完好,能完成性生活.结论 对比3种阴茎再造术,吻合血管游离肩胛皮瓣法存活率高,并发症发生率低,术后患者满意度高. Objective To compare the effect of three methods for penile reconstruction.Methods From Sept.2000 to Dec.2012,penile reconstruction was performed in 48 cases with free scapular flap transplantation,or pedicled superficial circumflex iliac artery skin flap,or anterolateral thigh skin flap pedicled with lateral circumflex femoral artery.The flaps were 12.0-14.5 cm in length,10-12 cm in width and the urethra perimeter was about 2-3 cm.Results Free scapular flaps were used in 21 cases,with flap failure in 3 cases due to insufficient blood supply.Malleable penile prosthesis was implanted in 11 cases,which was exposed in 3 cases.Groin skin flaps were used in 21 cases,with flap failure in 8 cases due to insufficient blood supply.Malleable penile prostheses were implanted in 7 cases,which was exposed in 3 cases.Anterolateral thigh skin flaps were used in 6 cases,with flap failure in 2 cases due to necrosis and infection.No prosthesis was implanted in this group.All the failure cases underwent secondary reconstruction with successful results.37 cases were followed up for 1-6 years,avevage 2.5 years.26 cases were satisfied with the results of appearance and function.Conclusions Among these three methods,the free scapular flap is most recommended for its high survival rate,low complication rate and high patient satisfaction.
