保留阴茎头手术在浅表性阴茎癌治疗中的应用

Glans-preserving surgery for superficial penile cancer

目的:探讨保留阴茎头手术治疗浅表性阴茎癌的安全性和可行性。方法:分析我院2003年1月至2010年3月间保留阴茎头手术治疗的21例浅表性阴茎癌患者的临床资料。结果:21例患者行保留阴茎头手术,年龄36～57岁,平均年龄46岁,阴茎癌病灶范围侵犯到阴茎头、冠状沟和阴茎体的皮肤组织。经临床分期分级,21例患者中,TaG1期6例、TaG2期5例、TisG1期2例、TisG2期4例、T1G1期3例、T1G2期1例。术后1个月均开始性生活,性功能和性满意度良好。21例随访2～7年,平均随访5年,2例患者分别于术后6个月和9个月出现原位肿瘤复发,经再次保留阴茎头手术治疗后,随访5年未再复发。结论:保留阴茎头的阴茎癌手术是治疗浅表性阴茎癌的有效方法之一。对合适的患者,不仅疗效安全,同时可最大限度保留阴茎的外观并使患者获得满意的性生活。

Objective： To investigate the safety and feasibility of glans-preserving surgery in the treatment of superficial penile cancer （SPCa）. Methods ： We retrospectively analyzed the clinical data of 21 cases of SPCa treated by glans-preserving surgery in our hospital from January of 2003 to March of 2010. Results ： The study included 21 SPCa patients aged 36 to 57 （ mean 46） years, with superficial lesions involving the glans penis, coronary sulcus or shaft skin. The tumors were staged and graded TaG1 in 6 cases, TaG2 in 5, TisG1 in 2, TisG2 in 4, T1G1 in 3, and T1G2 in 1. All the patients underwent glans-preserving surgery to preserve the normal appearance and functional integrity of the glans penis, and all returned to normal sexual activity 1 month after operation, with good sexual function and sexual satisfaction. Postoperative follow-up lasted 2 to 7 （ mean 5 ） years, and 2 cases of recurrence in situ found at 6 and 9 months, respectively, which were successfully managed by a second glans-preserving surgery. Conclusion ： Glanspreserving surgery is an effective method for superficial penile cancer. With proper selection of the patients, this procedure is technical- ly safe, maximally preserves the penile appearance, and least affects the patients＇sexual satisfaction.