带蒂岛状包皮瓣阴茎成形术与Sugita术矫治完全型隐匿阴茎的疗效比较  

Comparison of pedicled skin flap of foreskin for phalloplasty and Sugita surgical method in treatment of complete concealed penis

作　　者：徐奥 李雪[1] 张志博 曾莉[1] 黄一东[1] 马学[1] 黄鲁刚[1] XU Ao;LI Xue;ZHANG Zhibo;ZENG Li;HUANG Yidong;MA Xue;HUANG Lugang(Department of Pediatric Surgery,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China)

机构地区：[1]四川大学华西医院小儿外科,成都610041

出　　处：《中国修复重建外科杂志》2020年第11期1423-1428,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省科技重点研发项目(2017SZ0060)。

摘　　要：目的比较带蒂岛状包皮瓣阴茎成形术与Sugita术矫治完全型隐匿阴茎的疗效。方法回顾分析2016年1月—2018年1月收治的46例完全型隐匿阴茎患儿临床资料,其中采用带蒂岛状包皮瓣阴茎成形术治疗25例(A组),Sugita术治疗21例(B组)。年龄2岁8个月~11岁,平均4.7岁。术后3个月从术后阴茎增加长度(术后3个月阴茎长度与术前的差值)、阴茎外观、皮肤外观三方面对隐匿阴茎恢复情况进行评分(总分10分);收集患儿家长对手术矫治后阴茎显露情况、阴茎外观及包皮外观的满意程度评价。结果术后A组18例(72.0%)、B组15例(71.4%)患儿获完整随访,随访时间3~36个月,平均13个月。两组患儿切口均愈合良好,无皮瓣裂开、感染、坏死及阴茎勃起功能障碍发生。两组患儿术后3个月阴茎长度均较术前显著增加(P<0.05);两组间比较术前、术后3个月阴茎长度及增加长度,以及术后阴茎增加长度评分,差异均无统计学意义(P>0.05)。两组患儿术后均未出现阴茎回缩症状。两组患儿术后阴茎外观评分比较差异无统计学意义,但A组皮肤外观评分及总分均显著优于B组(P<0.05)。术后3个月患儿家长满意程度评价显示,A、B组术后阴茎显露情况满意率分别为88.9%、80.0%,差异无统计学意义(χ2=0.50,P=0.48);阴茎外观满意率分别为72.2%、53.3%,包皮外观满意率分别为94.4%、53.3%,差异均有统计学意义(χ2=5.13,P=0.03;χ2=7.53,P=0.01)。结论两种术式均适合于完全型隐匿阴茎的矫治,术后阴茎长度均恢复良好;但Sugita术后阴茎包皮淋巴水肿严重,阴茎外观较差;带蒂岛状包皮瓣阴茎成形术矫治效果优于Sugita术。Objective To evaluate the effectiveness of pedicled skin flap of foreskin for phalloplasty and Sugita surgical method in the treatment of complete concealed penis.Methods The clinical data of 46 children with complete concealed penis between January 2016 and January 2018 were analyzed retrospectively.Among which,25 cases were treated with pedicled skin flap of foreskin for phalloplasty(group A)and 21 cases were treated with Sugita surgical method(group B)with an average age of 4.7 years(range,2 years and 8 months to 11 years).At 3 months after operation,the concealed penis recovery was scored from three aspects of postoperative penis length(the difference of the penis length between at 3 months after operation and before operation),penis appearance,and skin appearance(the total score was 10).And the parents evaluation of satisfaction degree of penis exposure,penis appearance,and foreskin appearance after surgical correction was collected.Results Eighteen cases(72.0%)in group A and 15 cases(71.4%)in group B were followed up with an average of 13 months(range,3-36 months).The incisions healed well in both groups,and there was no flap dehiscence,infection,necrosis,and penile erectile dysfunction.The penile length of the two groups increased significantly at 3 months after operation(P<0.05);there was no significant difference between the two groups in terms of penis length and increased length at 3 months after operation and score of increase penis length after operation(P>0.05).No penile retraction occurred in the two groups.And there was no significant difference between the two groups in penis appearance score,but the penis appearance score,skin appearance score,and total score of group A were significantly better than those of group B(P<0.05).At 3 months after operation,the satisfaction rate of penis exposure in group A and group B was 88.9%and 80.0%,respectively,with no significant difference(χ2=0.50,P=0.48);the satisfaction rate of penis appearance was 72.2%and 53.3%,and the satisfaction rate of foreskin appea

关 键 词：完全型隐匿阴茎 带蒂岛状包皮瓣阴茎成形术 Sugita术 

分 类 号：R726.9[医药卫生—儿科]