阴茎头重建术治疗早期阴茎癌——阴茎部分切除+大腿内侧薄层皮片移植

Partial resection,inner thigh skin graft,and glans reconstruction for early-stage penile cancer:A report of 6 cases

目的：探讨早期阴茎癌阴茎部分切除术后阴茎头重建、保留性器官功能的最佳方法。方法：2012年1月~2015年6月,采用阴茎部分切除＋大腿内侧薄层皮片移植行阴茎头重建术治疗6例早期阴茎癌。随访0.5~3年,平均1.8年。结果：阴茎疲软状态下长度：术前（6.5±1.2）cm,术后（4.5±1.8）cm;勃起后长度：术前（12.8±2.3）cm,术后（9.1±2.1）cm。重建阴茎头感觉恢复迅速,术后3个月100%感觉恢复。术后随访见重建阴茎头皮肤呈淡红色,柔软,1年后接近正常阴茎头皮肤,远期未见皮片萎缩及瘢痕形成。6例术后均能正常勃起,无任何不适,性生活时感觉良好,与术前相似,患者及性伴侣均满意。所有病例未见复发及转移。结论：阴茎部分切除＋大腿内侧薄层皮片移植行阴茎头重建治疗早期阴茎癌,具有方法简便、疗效确切及并发症少等优点,是目前早期阴茎癌根治性切除肿瘤,同时又最大限度保留性器官功能的最好方法之一。

Objective： To explore the optimal methods for the reconstruction and preservation of the glans after partial penis resection in the treatment of early-stage penile cancer. Methods： Between January 2012 and June 2015,we treated 6 cases of earlystage penile cancer by partial penis resection,inner thigh skin graft,and glans reconstruction and followed them up for 0. 5- 3 years.Results： The length of the penis before and after operation was（ [6. 5 ± 1. 2] vs [4. 5 ± 1. 8] cm） in the flaccid state and（ [12. 8 ±2. 3] vs [9. 1 ± 2. 1] cm） in the erectile state. The sense of the reconstructed glans was completely recovered at 3 months after surgery. The glans skin was pale red and soft,nearly normal at 12 months,with no obvious graft contracture or scar formation. All the patients achieved normal erection and their partners were satisfied with their intercourse. No recurrence or metastasis was observed.Conclusion： The strategy of partial penis resection,inner thigh skin graft and glans reconstruction,simple,effective,and with few complications,is one of the best treatments of early-stage penile cancer,which not only ensures radical removal of the tumor but also maximally reserves the function of the organ.