Two-Stage Pediatric Penile Reconstruction after Postcircumcision Gangrene

Tarek Zayid, M. Ouf, Amr M. Elbatawy, Serag M. Zidan, Abdelnaser Hamdy, Hany M. Ismail, Khallad Sholkamy, H. Dahshan, W. Ayad
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引用次数: 1

Abstract

Abstract Background Postcircumcision penile gangrene is a devastating complication that may lead to total or subtotal penile loss requiring penile reconstruction. Pediatric penile reconstruction poses diverse challenges for most plastic surgeon. Patients and Methods Retrospective cohort study of 12 children ranged from 6 to 36 months old suffered from total or partial penile loss secondary to electrocautery burn during circumcisions. Reconstruction was done by island groin flap for phallus in first stage and urethral reconstruction by tubularized scrotal flap 6 months later. The outcome was evaluated by assessment of flap survival, the esthetic appearance, urethral competence and rate of complication. Results Follow-up was ranged from 6 to 24 months. A new phallus of satisfactory dimensions was achieved in all cases. Complications included partial necrosis of the flap in two cases, fistulas in two cases, and stenosis of the urethral anastomosis in one case. These complications were successfully resolved by corrective surgery. Good satisfactory result regarded as shape and urination stream. Conclusion Penile reconstruction can be performed in children with good results and low complication rate. The use of island groin flap for phallus reconstruction followed by urethral reconstruction by tubularized scrotal flap 6 months later was found effective, time saving, and with minor complication.
儿童包皮环切术后两期阴茎重建
摘要背景 包皮环切术后阴茎坏疽是一种破坏性并发症,可能导致阴茎全部或次全部丢失,需要进行阴茎重建。小儿阴茎重建给大多数整形外科医生带来了各种各样的挑战。患者和方法 对12名6至36个月大的儿童进行回顾性队列研究,这些儿童在包皮环切术中因电烧伤而导致阴茎完全或部分缺失。第一期采用腹股沟岛状皮瓣重建阴茎,6个月后采用阴囊管状皮瓣重建尿道。通过评估皮瓣的存活率、美观程度、尿道功能和并发症发生率来评估结果。后果 随访时间6~24个月。在所有病例中都获得了一个尺寸令人满意的新阴茎。并发症包括皮瓣部分坏死2例,瘘管2例,尿道吻合口狭窄1例。这些并发症通过矫正手术得以成功解决。以形体和小便流为佳,效果满意。结论 小儿阴茎重建效果好,并发症发生率低。应用腹股沟岛状皮瓣重建阴茎,6个月后用阴囊管状皮瓣重建尿道,效果好,省时,并发症少。
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