阴茎Paget病的手术治疗及随访(附10例报告)

Surgical treatment of penile Paget's disease:A report of 10 cases

目的：研究阴茎Paget病的临床特点并探讨其外科治疗的适宜方法。方法：回顾性分析江苏省人民医院及江苏省省级机关医院2008年至2012年外科治疗10例阴茎Paget病患者的治疗情况及随访资料。结果：所有10例患者都接受了局部扩大切除术，并用阴囊皮瓣或游离皮瓣对缺损处进行修补，手术顺利，术后阴囊皮瓣及游离皮瓣均存活，10例患者均无淋巴结转移。术前与术后1—2个月时的IIEF评分显示患者的勃起功能、性高潮及性生活满意度无显着性差异（P值分别为0．229、0．761和0．801）。结论：当阴茎皮损怀疑Paget病时，应尽早行活检，确诊后尽早行外科治疗。并根据患者病情，选择阴囊皮瓣或游离皮瓣进行修补，能够最大程度地保留阴茎术后形态和功能，是一种理想的首选治疗方法。

Objective： To investigate the clinical characteristics and surgical treatment of penile Paget＇s disease. Methods： We retrospectively analyzed the treatment and follow-up data of 10 cases of penile Paget＇s disease surgically treated in Jiangsu Provincial Govemment Hospital and Jiangsu Provincial People＇s Hospital from 2008 to 2012. Results ： All the 10 patients received expanded local resection of the lesion with reconstruction of the defects with serotal skin flaps or free skin flaps from the thigh. All surgeries were successful and the postoperative course was uneventful with complete graft survival and no lymph node metastasis. IIEF scores obtained before and 1 - 2 months after surgery showed no statistically significant differences in the penile erectile function （ P = 0.229 ）, sexual orgasm （ P = 0.761 ）, and sexual satisfaction （ P = 0. 801 ） of the patients. Conclusion ： When penile skin lesions suggest the possibility of Paget＇s disease, biopsy should be performed and surgery should follow as soon as possible. The ideal surgical option is expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free flaps according to the patient＇s specific conditions.