转移股前外侧皮瓣修复阴茎癌腹股沟淋巴结挽救性清扫术后皮肤缺损

Transferring of Anterolateral Thigh Flap for the Reconstruction of Skin Defect after Salvage Lvmlahadenectomy of Inguinal Lymph Node in Patients with Penile Carcinom~

【目的】探讨阴茎癌腹股沟淋巴结巨块转移灶挽救性清扫术后巨大皮肤缺损修复的手术方法。【方法】回顾性分析2012年5月至2012年11月本院收治的5例阴茎癌腹股沟淋巴结巨块转移灶患者的临床资料，并将具有代表性的病例作示例描述挽救性腹股沟淋巴结清扫术后缺损区以股前外侧皮瓣（Anterolater—alThigh，ALT）进行修复的方法，其中2例以单蒂单叶的AI，T修复缺损，另3例以单蒂双叶的ALT修复缺损。【结果15例带血管蒂的转移皮瓣均存活，1例出现血管危象，予减张后血管危象解除。病例1外侧皮瓣局部坏死（4cm×5cm），病例3供区局部皮肤坏死（4CiTI×2cm），予邮票状植皮后均愈合。腹股沟巨块淋巴结及破溃面清除，患者的生活质量明显提高，随访2～7个月，无肿瘤复发，无肌疝等并发症。【结论】股前外侧皮瓣可用于修复阴茎癌腹股沟巨块淋巴结转移灶挽救性清扫术后的皮肤缺损。

[Objective] To explore the surgical methods of the reconstruction of the giant skin defect in huge metastatic lesions of patients with penile carcinomas after salvage lymphadenectomy of inguinal lymphoid node. [Methods]Clinical data of 5 patients with large inguinal metastatic lesions of penile carcinomas admitted to our hospital from May 2012 to Nov. 2012 were analyzed retrospectively. Representative patients were taken as the examples to illustrate anterolateral thigh（ALT） flap for the reconstruction of defect regions after salvage lymphadenectomy of inguinal lymphoid node. Among them, 2 patients underwent the reconstruction with ALT flap of single pedicle and single leaf, and other 3 patients underwent the reconstruction with ALT flap of single pedicle and two leaves. [Results] All 5 pedicled ALT flaps were survived. Vascular crisis occurred in one pa- tient who was cured immediately after relaxation of tension of sutured incisions. One patient with local skin necrosis（4cm× 5cm） in the lateral side of ALT flap and 3 patients with local minimal skin necrosis（4cm× 2cm） in the donor site were cured with stamp like skin transplantation. Huge inguinal lymphoid node and the ulcera- ted masses were removed. The life quality of the patients was improved significantly. After following up for 2 7 months, no carcinoma recurred and no other complications were observed. [Conclusion] ALT flap can be used to reconstruct the skin defect in huge lymphoid node metastatic lesions of patients with penile carcinoma after salvage lymphadenectomy.