阴茎根部背侧皮肤梭形切除术治疗包皮过长和包茎

Treatment of redundant prepuce and phimosis by fusiform excision of dorsal skin of radix penis

目的探讨阴茎根部背侧皮肤梭形切除术治疗包皮过长和伴有包茎的手术方法及适应证。方法局部肿胀麻醉下，切除阴茎根部背侧梭形皮肤，用5-0可吸收线间断缝合真皮层和皮肤，并修剪切口两端的皮角，术后无须拆线；对包皮过长且伴有包茎者，在包皮环形狭窄口3点和9点处各纵行切开2—3mm（切断环形纤维索带），横行缝合2～3针即可，再行阴茎根部背侧皮肤梭形切除术。结果本组共110例患者，术后均未发生血肿、感染、坏死、感觉迟钝等并发症；阴茎外观自然，切口瘢痕隐蔽，包皮外口正常；均获随访1～6年，效果满意。结论阴茎根部背侧皮肤梭形切除术的方法简单、易行，保留了阴茎背侧皮下浅静脉、真皮下血管网、淋巴和感觉神经，有效地解决了传统包皮环切术后的并发症，手术安全、可靠，符合人体生理美学的修复，值得在临床上推广应用。

Objective To study the method and indications of prepuce with phimosis by fusiform excision of penis dorsal skin. Methods Under local tumescent anesthesia, spindle-shaped dorsal skin of radix penis was excised, then dermis and skin were performed the interrupted suture with 5-0 absorbable stitch. For the cases with redundant prepuce and phimosis, the longitudinal 2 to 3 mm incisions at Point 3 and Point 9 of annular stricture on the foreskin were performed firstly and then fusiform excision mentioned-above was carried out. Results All incisions healed on 110 cases without hematoma, infection, necrosis, insensitivity and other complications postoperatively. After 1 to 6 years following up, all cases were satisfied with the natural contour of the penis, concealed scar and normal foreskin. Conclusion The method is simple, safe and effective for the patients with the redundant prepuce and phimosis with dorsal subcutaneous superficial vein of penis, subdermal vascular plexus, lymph and sensory nerve reservation which effectively solves the postoperative complications caused by traditional circumcision. The method is worthy to be widely promoted.