摘要
目的探讨采用经阴茎腹侧阴囊衔接处楔形裁剪联合改良Brisson术矫治先天性隐匿阴茎的疗效。方法 2010年3月-2012年6月,对68例先天性隐匿阴茎患儿采用经阴茎腹侧阴囊衔接处楔形裁剪联合改良Brisson术矫治。年龄3个月～13岁,中位年龄4岁10个月。隐匿阴茎分型:包茎型14例,索带型14例,中度型20例,重度型20例。阴茎体发育良好,均未合并畸形。术后观察并发症发生情况,采用自行设计随访问卷评定疗效。结果术后早期11例发生并发症,其中包皮外口明显粘连4例,阴囊皮肤肿胀5例,包皮远端坏死2例;远期9例发生并发症,其中腹部切口瘢痕形成4例,包皮口瘢痕狭窄3例,阴茎短小2例。其余患儿切口均Ⅰ期愈合。术后54例获随访,随访时间6～12个月,平均8个月。术后6个月根据自行设计随访问卷评定,患儿家长对术后整体观效果满意率达77.78%(42/54),认为临床症状完全改善率达85.19%(46/54);其中50例家长对阴茎显露满意,46例家长对患儿阴茎显露情况无心理负担,均显著优于术前(P<0.05);术后29例(53.70%)患儿自身对阴茎显露情况无心理负担,与术前18例(33.33%)比较,差异无统计学意义(χ2=1.22,P=0.31)。结论应用经阴茎腹侧阴囊衔接处楔形裁剪联合改良Brisson术可有效矫治先天性隐匿阴茎。
Objective To investigate the effectiveness of the penile ventral scrotum cohesion place wedge cutting and improved Brisson technique for congenital buried penis. Methods Between March 2010 and June 2012, 68 boys with congenital buried penis were treated by the penile ventral scrotum cohesion place wedge cutting and improved Brisson technique, with a median age of 4 years and 10 months （range, 3 months-13 years）. Of 68 cases, 14 were classified as phimosis type, 14 as rope belt type, 20 as moderate type, and 20 as severe type. The body of penis developed well and had no deformity. After operation, complications were observed, and the effectiveness was evaluated by the designed questionnaire. Results Early postoperative complications occurred in 11 cases, including obvious adhesion of the outside wrapping mouth in 4 cases, scrotal skin bloat in 5 cases, and distal foreskin necrosis in 2 cases; long-term complications occurred in 9 cases, including abdominal incision scar formation in 4 cases, wrapping mouth scar stricture in 3 cases, and short penis in 2 cases. Primary healing of incision was obtained in the other boys. Fifty-four cases were followed up 6-12 months （mean, 8 months）. According to the designed questionnaire, satisfaction rate with the overall view in parents was 77.78% （42/54）; the cl inical improvement rate was 85.19% （46/54）; exposure of the penis was satisfactory in parents of 50 cases; and the parents had no psychological burden of penis exposure in 46 cases, which were significantly improved when compared with preoperative ones （P 〈 0.05）. The boys had no psychological burden of penis exposure in 29 cases （53.70%） after operation, showing no significant difference when compared with preoperative one （18 cases, 33.33%）（χ2=1.22, P=0.31）. Conclusion Application of the penile ventral scrotum cohesion place wedge cutting and improved Brisson technique can effectively correct congenital buried penis.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2013年第9期1102-1105,共4页
Chinese Journal of Reparative and Reconstructive Surgery
