改良Brisson术联合阴茎阴囊角重建术和Devine术治疗隐匿性阴茎的疗效比较  

Comparison of modified Brisson surgery combined with penis-scrotum triangle reconstruction and Devine surgical method in treatment of concealed penis

作　　者：张兆林[1] 黄若辉 曾庆明[1] 刘林伟[1] 何小红 袁源湖[1] 陈汉民[1] 吴玉婷[1] Zhang Zhaolin;Huang Ruohui;Zeng Qingming;Liu Linwei;He Xiaohong;Yuan Yuanhu;Chen Hanmin;Wu Yuting(Department of Urology,First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,Jiangxi,China;Department of Urology,Second Afiliated Hospital of Gannan Medical University,Xinfeng 341600,Jiangxi,China)

机构地区：[1]赣南医学院第一附属医院泌尿外科,江西赣州341000 [2]赣南医学院第二附属医院泌尿外科,江西信丰341600

出　　处：《中国男科学杂志》2023年第5期75-80,共6页Chinese Journal of Andrology

基　　金：赣州市科学技术局研究项目(GZ2018ZSF077)。

摘　　要：目的比较改良Brisson术联合阴茎阴囊角重建术和Devine术治疗儿童隐匿性阴茎的临床疗效。方法回顾性分析2018年7月至2021年7月赣南医学院第一附属医院收治的64例隐匿性阴茎患儿的临床资料,按手术方式分为改良Brisson术联合阴茎阴囊角重建术组(Brisson组,33例)和Devine术组(Devine组,31例),比较两组患儿年龄、手术时间、阴茎外露长度增加值、术后并发症、术后满意度等指标。结果64例手术均顺利。Brisson组和Devine组的患儿年龄[(7.34±2.95)years vs.(7.65±2.32)years,P=0.629]和术前阴茎外露长度[(1.39±0.25)cm vs.(1.48±0.19)cm,P=0.124]比较无统计学差异。Brisson组与Devine组比较,手术时间[(50.39±4.32)min vs.(51.48±5.68)min,P=0.389]、阴茎外露长度增加值[(2.22±0.24)cm vs.(2.28±0.31)cm,P=0.381]、术后并发症发生率(9.09%vs.19.35%,P=0.412)均无明显统计学差异。术后6个月,Brisson组阴茎外观满意度优于Devine组(P=0.03),而显露效果满意度两组间无明显差异(P=0.283),整体效果满意度评分Brisson组(8.58±0.71)高于Devine组(8.06±0.81),差异具有统计学意义(P=0.009)。术后随访9~36个月,所有患者均未见继发性包茎、顽固性水肿。结论改良Brisson术联合阴茎阴囊角重建术和Devine术治疗儿童隐匿性阴茎均安全有效,前者在术后外观满意度和整体效果满意度评分更具有优势。Objective To evaluate clinical effectiveness of modified Brisson surgery combined with penis-scrotum triangle reconstruction and Devine surgical method in the treatment of concealed penis in Children.Methods Clinical data of 64 children with concealed penis who received surgery from July 2018 to July 2021 were retrospectively analyzed.All the patients were divided into two groups based on surgical styles including modified Brisson surgery combined with penis-scrotum triangle reconstruction group(Brsson group,33 cases)and Devine surgical method group(Devine group,31 cases).Age,preoperative length of penis exposure,operation time,increased length of penis exposure,postoperative complications and postoperative satisfaction of two groups were comparatively analyzed.Results Surgical procedures of 64 patients were all successfully performed without intraoperative complications.No significant differences were observed between two groups in age[(7.34±2.95)years us.(7.65±2.32)years,P=0.629],preoperative length of penis exposure[(1.39±0.25)cm vs.(1.48±0.19)cm,P=0.124],mean operation time[(50.39±4.32)min us.(51.48±5.68)min],mean increased length of penis exposure[(2.22±0.24)cm us.(2.28±0.31)cm],and complication rates(9.09%us.19.35%).Postoperative 6 months,patients in Brisson group had better penis appearance satisfaction than the patients in Devine group(P=0.03),no significant difference of extend satisfaction was seen in both groups(P=0.283).The mean total effect satisfaction score of Brisson group(8.58±0.71)was significantly higher than that of Devine group(8.06±0.81,P=0.009).During follow-up of 9-36 months,no secondary phimosis,intractable prepuce edema occurred in all patients.Conclusion Modified Brisson surgery combined with penis-scrotum triangle reconstruction and Devine surgical method are effective and safe for the therapy of concealed penis in children,however,the former surgery shows obvious advantage in postoperative penis appearance satisfaction and total satisfaction score.

关 键 词：隐匿性阴茎 改良Brisson术 阴茎阴囊角重建术 DEVINE术 儿童 

分 类 号：R699.8[医药卫生—泌尿科学] R697.11[医药卫生—外科学]