CAJ | 학술논문

目的探讨采用4种不同手术径路行阴茎延长术的疗效及体会.方法分别采用经腹壁Y或Z形切口、冠状沟环切口,以及Z形与经冠状沟环切口(联合切口),切开阴茎皮肤和筋膜,再将阴茎皮肤及筋膜松解分离脱套至根部,切断阴茎背浅、深悬韧带,残端电凝后缝合耻骨联合前两侧组织,然后将阴茎皮肤及筋膜一同复位,便环形缝合冠状沟切口内、外板,阴茎体后1/3处丝线分别缝合固定2针.结果 2003年7月至2014年10月,对674例阴茎短小患者,经腹壁Y形切口整形12例,术后阴茎静态下延长(2.9±0.2)cm;经腹壁改良Z形切口260例,术后延长(3.1±0.3)cm;经冠状沟环切口363例,术后延长(3.9±0.7)cm;联合切口39例,术后延长(3.4±0.8)cm,经冠状环切口术后延长长度与腹壁Y、Z形切口比较,差异有统计学意义(P＜0.05).术后随访6个月至5.5年,无严重并发症发生,仅3例术后皮下血肿者经清创引流后痊愈;4例阴茎皮肤远端表层缺血性坏死,经清创、换药、理疗后皮肤恢复正常,无瘢痕.结论上述4种径路阴茎延长术均安全有效,但以经冠状沟环切口效果最佳.
목적 탐토채용4충불동수술경로행음경연장술적료효급체회.방법 분별채용경복벽Y혹Z형절구、관상구배절구,이급Z형여경관상구배절구(연합절구),절개음경피부화근막,재장음경피부급근막송해분리탈투지근부,절단음경배천、심현인대,잔단전응후봉합치골연합전량측조직,연후장음경피부급근막일동복위,편배형봉합관상구절구내、외판,음경체후1/3처사선분별봉합고정2침.결과 2003년7월지2014년10월,대674례음경단소환자,경복벽Y형절구정형12례,술후음경정태하연장(2.9±0.2)cm;경복벽개량Z형절구260례,술후연장(3.1±0.3)cm;경관상구배절구363례,술후연장(3.9±0.7)cm;연합절구39례,술후연장(3.4±0.8)cm,경관상배절구술후연장장도여복벽Y、Z형절구비교,차이유통계학의의(P＜0.05).술후수방6개월지5.5년,무엄중병발증발생,부3례술후피하혈종자경청창인류후전유;4례음경피부원단표층결혈성배사,경청창、환약、리료후피부회복정상,무반흔.결론 상술4충경로음경연장술균안전유효,단이경관상구배절구효과최가.
Objective To investigate the curative effect of penile elongation with four different operative approaches.Methods Through four different operative approaches (the coronary sulcus ring incision, Y or Z shaped incision or Z shaped incision combined with coronary sulcus ring incision) , the penile skin and fascia were degloved until the penile root.Then the superficial and deep dorsal penile suspensory ligament were cut off.After electric coagulation of the residue ends, the two-side tissue at the front of the pubic symphysis was sutured.Then the penile skin and fascia were repositioned and the incision at the inner and outer plate was closed.Results The increased penile static length was (2.9 ± 0.2) cm with abdominal wall Y incision(12 cases);(3.1 ±0.3) cm with transabdominal modified Z incision(260 cases);(3.9 ±0.7) cm with coronary sulcus ring incision(363 cases);(3.4 ±0.8) cm with combined incision (39 cases).The lengthening effect was significantly different between the coronary ring incision and abdominal wall Y/Z incision (P ＜ 0.05).The postoperative follow-up period was 6 months to 5.5 years without serious complications.Only 3 cases of subcutaneous hematoma occurred with treatment of debridement and drainage.4 cases with ischemic necrosis at distal penile skin, were treated with debridement, dressing and physiotherapy, leaving no scar.Conclusions Penile lengthening surgery are safe and effective through different approaches.The coronal ring incision has the best therapeutic effect.