阴囊纵隔皮瓣法阴茎延长术保留阴茎癌患者术后排尿及勃起功能的临床研究

Clinical study of urinary and erectile function in patients with penile cancer after penile lengthening by scrotal mediastinal flap

目的探讨行阴茎部分切除术的阴茎癌患者,同期行阴囊纵隔皮瓣法阴茎延长术的疗效和术后站立排尿能力和性功能保留情况。方法21例阴茎癌患者被分为阴茎延长组(penile lengthening group,Gpl)(9例)和单纯阴茎部分切除组(partial penectomy group,Gpp)(12例),阴茎延长术采用阴囊纵隔全厚游离肌皮瓣移植法,观察术后阴茎疲软拉伸长度(stretched flaccid length,SFL)、站立排尿能力和勃起功能。结果两组患者基线资料无显著差异,GPL组的总体T分级高于Gpp组(P=0.027),术后两组的阴茎残端SFL、术后两组站立排尿能力和勃起功能状况均无统计学差异(P=0.460,P=0.603;P=0.939)。结论对于术前T分级相对较高、预计阴茎残端保留较短的阴茎癌患者,采用阴囊纵隔皮瓣法行同期阴茎延长术,可在有效延长患者术后阴茎残端长度的同时,保留站立排尿能力及一定的勃起功能。

Objective To study the effectiveness and feasibility of penile advancement with a scrotal septal flap in the treatment of penile cancer patients,evaluating the ability to urinate standing up and maintenance of erectile function after surgery.Methods Twenty-one patients with penile cancer were divided into penile lengthening group(Gpl)and penile partial penectomy group(Gpp).Partial penectomy or penectomy with scrotal septal flap penile lengthening was performed,the group thus determined.The stretched flaccid length(SFL)of the residual penis stump,maintenance rate of urinate standing up and erectile function of both groups after surgery were compared.Results The Gpl patients had a higher T grade in total composition ratio(P=0.027),but no significant difference was found between Gpl and Gpp in penile stump SFL after surgery,maintenance rate of urinate standing up,and post-operative erectile function(P=0.460;P=0.603;P=0.939).Conclusion Penile lengthening with a scrotal septal flap is effective and feasible for penile cancer patients with relatively higher T grade to preserve patients’residual penis stump and maintain the ability to urinate standing up and erectile function.