阴股沟皮瓣在男性外生殖器恶性肿瘤根治术后创面修复中的应用  

Application of pudendal thigh flaps in repairing soft tissue defect after male genitalia tumor resection

作　　者：李顺堂[1] 刘德云[2] 石源 李生华[2] 农庆文[1] 高兴新[1] 吴亚军 钟朝议 刘达恩[1] Li Shuntang;Liu deyun;Shi Yuan;Li Shenghua;Nong Qingwen;Gao Xingxin;Wu Yajun;Zhong Chaoyi;Liu Daen(Department of Burns and Plastic Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Urology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院烧伤整形外科,南宁530021 [2]广西医科大学第一附属医院泌尿外科,南宁530021

出　　处：《广西医科大学学报》2021年第4期790-794,共5页Journal of Guangxi Medical University

基　　金：广西再生医学重点实验室开放课题资助项目(No.桂再重开1704)。

摘　　要：目的:探讨以蒂在上的阴股沟皮瓣转移联合植皮的修复方法在男性外生殖器恶性肿瘤根治术后创面修复中的应用效果。方法:选取广西医科大学第一附属医院泌尿外科和烧伤整形外科2015年3月至2020年8月共同诊治的男性外生殖器恶性肿瘤患者18例,其中阴茎鳞状细胞癌6例,阴囊鳞状细胞癌4例,阴囊Paget病8例。行恶性肿瘤根治性切除术,根据创面所在部位及大小选择蒂在上的单侧或双侧阴股沟皮瓣转移覆盖阴囊区,残缺创面行中厚皮植皮修复。结果:18例患者行肿瘤根治性切除术后创面缺损面积范围为6 cm×8 cm~19 cm×12 cm,根据缺损创面所在的解剖分区及大小采用单侧或双侧阴股沟皮瓣转移联合植皮的方法进行修复,术后皮瓣全部成活,术后随访3个月至18个月,皮瓣质地良好,其中2例阴茎鳞状细胞癌患者肿瘤复发。结论:蒂在上部的阴股沟皮瓣血供确切,设计灵活,对供区损伤小,灵活选择单侧或双侧阴股沟皮瓣转移并联合植皮修复男性外生殖器恶性肿瘤根治术后的缺损创面,能获得良好的手术效果。Objective: To investigate the effect of pudendal-thigh flaps pedicled above combined with skin grafting in repairing soft tissue defects after radical resection malignant tumor in the male external genitalia. Methods: A total of 18 patients with male external genital cancer were enrolled, including 6 cases of penile squamous cell carcinoma, 4 cases of scrotal squamous cell carcinoma,and 8 cases of Paget’s disease of the scrotum, aged 22 to 77 years with an average of 52 years. After radical malignant tumor resection were performed byurologist, plastic surgeon adopted unilateral or bilateral pudendal-thigh flap pedicled above metastasis(11 cases with unilateral flap and 7 cases with bilateral flaps) combined with skin grafting to repair soft tissue defects. Results: Among the18 patients, the area of defects after radical tumor resection ranged from 6 cm×8 cm to 19 cm×12 cm, unilateral or bilateral pudendal flaps pedicled above and skin grafting were used to repair soft tissue defects according to the anatomical area and size of the defect. All flaps survived;the follow-up period ranged from 3 to 18 months.The texture was good and had a good outline and sense function. Among them, 2 patients with penile squamous cell carcinoma had tumor recurrence. Conclusion: The pudendal-thigh flap pedicled above has a good quality of blood supply and a high survival rate. Selecting flexibly with unilateral or bilateral flap pedicled above transfer and combined with skin grafting to repair extensive soft tissue defects after radical resection malignant tumor of male external genitalia, which can obtain good surgical results.

关 键 词：恶性肿瘤 男性外生殖器 阴股沟皮瓣 修复重建 

分 类 号：R622[医药卫生—整形外科]