应用e-PTFE植入再造阴茎远端龟头成形术.docVIP

应用e-PTFE植入再造阴茎远端龟头成形术［摘要］目的：使用膨体聚四氟乙烯（e-PTFE）植入再造阴茎体远端，使形成龟头以改善再造阴茎外形。方法：使用规格型号为0.5cm1×5cm×6.5cm的e-PTFE块状材料雕刻成一上薄下厚，外光内糙的2/3圈圆锥状结构，包绕再造尿道，一期植入再造阴茎远端。 结果：2002年～2007年共完成23例，再造阴茎全部成活，龟头形态良好，无植入物外露发生，2例发生尿瘘，1例因反复伤口感染而取出植入物。结论：阴茎再造时一期植入e-PTFE材料用于形成龟头，是一种安全、有效的阴茎再造龟头成形方法。 [关键词]膨体聚四氟乙烯（e-PTFE）；阴茎再造术；龟头成形术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）03-03 Improving the appearance of the neoglans by implanting carved e-PTFE at the distal part of the reconstructed phallus during phalloplasty LIU Yang, CHENG Kai-xiang, WANG Shan-liang, CAO Wei-gang, LI Sheng-li (Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Medical College, Shanghai Jiaotong University, Shanghai 200011, China) Abstract:ObjectiveTo improve the appearance of the reconstructed phallus by implanting carved e-PTFE at the distal part of the neophallus.MethodsA strip-shaped e-PTFE sized 0.5 cm×1.5 cm×6.5 cm was carved and sutured to forma structure like 2/3 circle pyramid , which was implanted at the distal part of the reconstructed phallus with the neourethra being wrapped within it.ResultsDuring 2002 to 2007, 23 male patients received phalloplasty by the way as the above, all reconstructed phalli survived completely with satisfactory appearance, implant exposure occurred in none case and urinary fistula occurred in 2 cases, in another 1 case the implant was dissected out at last for recurrent incision infections.ConclusionImplanting the carved e-PTFE to the distal part of the reconstructed phallus at the first stage of phalloplasty is a safe and effective way to make the neoglans with an acceptable appearance. Key words: expanded polytetrafluoroethylene(e-PTFE); phalloplasty; glans plasty 具有逼真的外形是阴茎再造术的目标之一，而再造阴茎龟头的形态对整个再造阴茎的外形举足轻重。以往有关文献报道的方法各不相同[1-5]，但长期随访结果并不令人满意。我们从2002年起应用e-PTFE作为填充物植入再造阴茎远端改善龟头外形，取得较满意效果，现报道如下。 1资料和方法 1.1病例资料：本组患者为2002年～2007年在我科行阴茎再造术者共23例，患者全部为男性，其中先天性小阴茎10例，外伤后阴茎缺损13例。患者年龄19～60岁。阴茎再造方法采用前臂皮瓣游离移植（14例）或足背+前臂复合串联皮瓣游离移植（9例）分两期完成。e-PT