Zhang Ye,You Long,Jiang Jiabin,et al.Comparison of therapeutic efficacy of two kinds of skin flap covering for severe concealed penis in children[J].Journal of Clinical Pediatric Surgery,2021,20(09):852-856.[doi:10.12260/lcxewkzz.2021.09.010]
两种皮瓣覆盖方法在儿童重度隐匿性阴茎手术中的应用
- Title:
- Comparison of therapeutic efficacy of two kinds of skin flap covering for severe concealed penis in children
- Keywords:
- Penis/AB; Surgical Flaps; Surgical Procedures; Operative; Comparative Effectiveness Research; Child
- 分类号:
- R726.971.1;R726.9
- 摘要:
- 目的 比较横裁带蒂岛状包皮瓣与阴茎根部腹侧推进皮瓣在儿童重度隐匿性阴茎手术中的应用效果。方法 回顾性分析安徽省儿童医院2019年1月至2020年8月收治的47例重度隐匿性阴茎患者临床资料，平均年龄6.76岁，A组（19例）采用横裁带蒂岛状包皮瓣法，B组（28例）采用阴茎根部腹侧推进皮瓣法，比较两组手术时间、包皮外板/阴茎体长度（S/P）比值、术后并发症发生率及术后3个月阴茎体显露情况、包皮外观以及阴茎整体外观评分。结果 两组47例术后均获得随访，随访时间平均7.68个月。两组患者年龄（t=-1.340，P=0.187）、S/P比值差异无统计学意义（t=-0.362，P=0.720）；A组平均手术时间显著长于B组（t=4.286，P<0.001）；A组术后顽固性淋巴水肿发生率显著高于B组（χ2=7.499，P=0.006）；A组切口裂开发生率显著低于B组（χ2=7.677，P=0.006）；两组总体并发症发生率差异无统计学意义（χ2=0.703，P=0.402）。两组术后3个月阴茎体显露、包皮外观、阴茎整体外观评分及总分差异均无统计学意义（P>0.05）。结论 横截带蒂岛状包皮瓣法与阴茎根部腹侧推进皮瓣法均适用于儿童重度隐匿性阴茎的矫治，阴茎根部腹侧推进皮瓣法相对更值得推广。
- Abstract:
- Objective To explore the therapeutic efficacy of transverse pedicled island flap versus proximal propulsion skin flap covering for severe concealed penis in children.Methods Clinical data were retrospectively reviewed for 47 children with severe concealed penis undergoing phalloplasty between January 2019 and August 2020.The average age was 6.76 years.They were divided into group A (n=19) with transverse pedicled island flap covering and group B (n=28) with proximal propulsion skin flap covering.Operative duration, penile skin/penile shaft (S/P) ratio and complication rate were compared.At 3 months post-operation, concealed penis recovery was scored from penile exposure, foreskin appearance and penile appearance and the scores were compared.Results The average follow-up period was 7.68 months.No significant inter-group differences existed in age (t=-1.340, P=0.187) or S/P ratio (t=-0.362, P=0.720).Operative duration was significantly longer in group A than that in group B (t=4.286, P<0.001).After operation, the incidence of persistent lymphedema of prepuce in group A was significantly higher than that of group B (χ2=7.499, P=0.006) and the incidence of incision disruption in group B was significantly higher than that of group A (χ2=7.677, P=0.006).No significant inter-group difference existed in overall complication rate (χ2=0.703, P=0.402).Inter-group differences in penile exposure score, foreskin appearance score, penis appearance score and total score were not statistically significant.Conclusion Both skin flap coverings are suitable for correcting severe concealed penis in children.And proximal propulsion skin flap covering is superior since it is relatively easier to operate and achieve an excellent penile appearance.
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备注/Memo
收稿日期:2021-04-16。
基金项目:安徽省卫生健康委课题（编号：2019SEY006）
通讯作者:潮敏,Email:cm0654@sina.com