应用腹膜管联合皮瓣行兔阴茎再造的初步研究  

Penile reconstruction using skin flap and peritoneal tube grafts in rabbit: a preliminary study

作　　者：张旭东[1] 杨松林[1] 朱晓海[1] 江华[1] 袁相斌[1] 吴包金[1] 

机构地区：[1]第二军医大学附属长征医院整形外科

出　　处：《中华医学美学美容杂志》2003年第1期30-32,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的　建立皮瓣包绕游离腹膜管再造阴茎的动物模型 ,探索在阴茎再造术中使用腹膜再造尿道的新方法。方法　成年雄性新西兰大白兔 2 4只 ,随机分成腹膜组和腹膜皮片组各 12只。再造阴茎时 ,腹膜组中将腹膜浆膜面向内缝合成腹膜管替代尿道 ,腹膜皮片组则在腹膜管前端吻接一段 1cm长的阴囊皮片 ,形成腹膜皮片复合管 ,并以此管替代尿道 ,两组均以腹壁浅血管筋膜蒂皮瓣包绕再造尿道形成阴茎体 ,观察阴茎成活和尿道通畅情况。结果　再造阴茎全部成活 ,无尿道狭窄发生 ,作为尿道衬里的腹膜浆膜面光滑、湿润、富有光泽 ,未见溃疡及纤维化。腹膜组 8只兔尿道口闭合 ,同时伴有尿瘘。腹膜皮片组 3只兔各 1处尿瘘。结论　使用皮瓣包绕游离腹膜管再造阴茎的方法可以成功构建阴茎再造的动物模型 ,为游离腹膜联合皮瓣转移阴茎再造术的临床应用提供了实验依据。Objective To investigate a new method for the reconstruction of the urethra using peritoneal free grafts in phalloplasty in a rabbit model. Methods Animal models were established in 24 adult male New Zealand white rabbits, which were randomly divided into the peritoneal graft group (n=12) and peritoneum-skin graft group (n=12). In the former group the peritoneal tube grafts with the mesothelial surface inward were used as the urethral substitutes. And a circumferential 1 cm rim of scrotal skin was inserted at the tip of the tubularized peritoneal graft for urethroplasty in the latter group. Subsequently, a superficial epigastric fasciovascular pedicle flap for phalloplasty was harvested and tubed over the reconstructed urethra. The process of growth was observed grossly. Results The reconstructed penis survived well without urethral stricture, and the peritoneal-lined grafts survived in all rabbits with a smooth, moist quality and without ulceration and fibrosis. Gross examination showed 8 meatal occlusions with fistulas simultaneously in the peritoneal graft group, and 3 fistulas in the peritoneum-skin graft group. Conclusion The authors have successfully designed the rabbit model of the urethroplasty using the tubularized peritoneal free grafts in the penile reconstruction and demonstrated the possibility of the new method for phalloplasty brings a light to clinical study.

关 键 词：腹膜管 联合皮瓣转移 兔 阴茎再造 

分 类 号：R699.8[医药卫生—泌尿科学]