阴茎再植术:显微外科技术、患者疗效及复杂重建难题解决方案综述

IF 0.7 4区 医学 Q4 SURGERY
Eylon J. Arbel, Alyssa D. Reese, Raymond Richards, Simran Singh, Aidan W. O’Shea, Finn Hennig, David Abramowitz
{"title":"阴茎再植术:显微外科技术、患者疗效及复杂重建难题解决方案综述","authors":"Eylon J. Arbel, Alyssa D. Reese, Raymond Richards, Simran Singh, Aidan W. O’Shea, Finn Hennig, David Abramowitz","doi":"10.1177/22925503241265299","DOIUrl":null,"url":null,"abstract":"Introduction: Penile amputation is a rare urological emergency with varying etiologies, ranging from psychiatric disorders to traumatic injuries, and requires precise microsurgical replantation techniques to restore function and appearance. The popularization of microsurgery has greatly improved outcomes by enabling accurate vascular and nerve reattachments, which are crucial for erectile function and sensation. This comprehensive study reviews advancements in microsurgical penile replantation, perioperative, and postoperative care, focusing on the nuances of surgical interventions and potential complications such as ischemia and necrosis. Methods: The PubMed, EMBASE, and Cochrane databases, were queried for studies published between 2015 and 2023 that discussed preoperative conditions, surgical techniques, and postoperative outcomes in penile replantation cases. Resulting studies that reported preoperative and postoperative outcomes of at least one case of penile replantation after amputation were included. Case parameters of interest were then extracted and categorized to determine the most common complications as well as solutions utilized in penile replantation. Results: Our findings from 46 cases across 37 studies revealed a common occurrence of postoperative necrosis (56.5%) and highlighted the importance of timely vascular reconnection and innovative surgical strategies to manage complications. Three cases were complicated by scrotal hematomas and 23 cases reported at least one psychiatric comorbidity. Some innovative solutions mentioned include hyperbaric oxygen therapy, laser angiography, leech therapy, PDE inhibitors, and penile splints. Conclusion: The outcomes suggest a critical need for standardized protocols and further research into optimizing techniques and therapies to enhance the success rates as well as quality of life post-replantation. This review aims to guide future practices and encourage collaborative efforts to refine the complex microsurgical procedures involved in penile replantation.","PeriodicalId":20206,"journal":{"name":"Plastic surgery","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Penile Replantation: A Review of Microsurgical Techniques, Patient Outcomes, and Solutions to Complex Reconstructive Challenges\",\"authors\":\"Eylon J. Arbel, Alyssa D. Reese, Raymond Richards, Simran Singh, Aidan W. O’Shea, Finn Hennig, David Abramowitz\",\"doi\":\"10.1177/22925503241265299\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Penile amputation is a rare urological emergency with varying etiologies, ranging from psychiatric disorders to traumatic injuries, and requires precise microsurgical replantation techniques to restore function and appearance. The popularization of microsurgery has greatly improved outcomes by enabling accurate vascular and nerve reattachments, which are crucial for erectile function and sensation. This comprehensive study reviews advancements in microsurgical penile replantation, perioperative, and postoperative care, focusing on the nuances of surgical interventions and potential complications such as ischemia and necrosis. Methods: The PubMed, EMBASE, and Cochrane databases, were queried for studies published between 2015 and 2023 that discussed preoperative conditions, surgical techniques, and postoperative outcomes in penile replantation cases. Resulting studies that reported preoperative and postoperative outcomes of at least one case of penile replantation after amputation were included. Case parameters of interest were then extracted and categorized to determine the most common complications as well as solutions utilized in penile replantation. Results: Our findings from 46 cases across 37 studies revealed a common occurrence of postoperative necrosis (56.5%) and highlighted the importance of timely vascular reconnection and innovative surgical strategies to manage complications. Three cases were complicated by scrotal hematomas and 23 cases reported at least one psychiatric comorbidity. Some innovative solutions mentioned include hyperbaric oxygen therapy, laser angiography, leech therapy, PDE inhibitors, and penile splints. Conclusion: The outcomes suggest a critical need for standardized protocols and further research into optimizing techniques and therapies to enhance the success rates as well as quality of life post-replantation. This review aims to guide future practices and encourage collaborative efforts to refine the complex microsurgical procedures involved in penile replantation.\",\"PeriodicalId\":20206,\"journal\":{\"name\":\"Plastic surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2024-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Plastic surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/22925503241265299\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/22925503241265299","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

摘要

导言:阴茎截肢是一种罕见的泌尿外科急症,病因各异,有精神疾病,也有外伤,需要精确的显微外科再植技术来恢复功能和外观。显微外科技术的普及极大地改善了治疗效果,因为它能准确地重新连接血管和神经,而这对勃起功能和感觉至关重要。本研究全面回顾了显微外科阴茎再植、围手术期和术后护理的进展,重点关注手术干预的细微差别以及缺血和坏死等潜在并发症。方法:在PubMed、EMBASE和Cochrane数据库中查询2015年至2023年间发表的、讨论阴茎再植病例术前条件、手术技术和术后结果的研究。结果纳入了报告至少一例截肢后阴茎再植术的术前和术后结果的研究。然后提取感兴趣的病例参数并进行分类,以确定最常见的并发症以及阴茎再植术中使用的解决方案。结果:我们从 37 项研究的 46 个病例中发现,术后坏死(56.5%)是常见的并发症,并强调了及时重建血管和创新手术策略对控制并发症的重要性。有 3 个病例并发阴囊血肿,23 个病例报告了至少一种精神并发症。其中提到的创新解决方案包括高压氧疗法、激光血管造影术、水蛭疗法、PDE 抑制剂和阴茎夹板。结论研究结果表明,亟需制定标准化方案,并进一步研究优化技术和疗法,以提高移植手术的成功率和术后生活质量。本综述旨在为未来的实践提供指导,并鼓励各方共同努力,完善阴茎再植术所涉及的复杂显微外科手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Penile Replantation: A Review of Microsurgical Techniques, Patient Outcomes, and Solutions to Complex Reconstructive Challenges
Introduction: Penile amputation is a rare urological emergency with varying etiologies, ranging from psychiatric disorders to traumatic injuries, and requires precise microsurgical replantation techniques to restore function and appearance. The popularization of microsurgery has greatly improved outcomes by enabling accurate vascular and nerve reattachments, which are crucial for erectile function and sensation. This comprehensive study reviews advancements in microsurgical penile replantation, perioperative, and postoperative care, focusing on the nuances of surgical interventions and potential complications such as ischemia and necrosis. Methods: The PubMed, EMBASE, and Cochrane databases, were queried for studies published between 2015 and 2023 that discussed preoperative conditions, surgical techniques, and postoperative outcomes in penile replantation cases. Resulting studies that reported preoperative and postoperative outcomes of at least one case of penile replantation after amputation were included. Case parameters of interest were then extracted and categorized to determine the most common complications as well as solutions utilized in penile replantation. Results: Our findings from 46 cases across 37 studies revealed a common occurrence of postoperative necrosis (56.5%) and highlighted the importance of timely vascular reconnection and innovative surgical strategies to manage complications. Three cases were complicated by scrotal hematomas and 23 cases reported at least one psychiatric comorbidity. Some innovative solutions mentioned include hyperbaric oxygen therapy, laser angiography, leech therapy, PDE inhibitors, and penile splints. Conclusion: The outcomes suggest a critical need for standardized protocols and further research into optimizing techniques and therapies to enhance the success rates as well as quality of life post-replantation. This review aims to guide future practices and encourage collaborative efforts to refine the complex microsurgical procedures involved in penile replantation.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Plastic surgery
Plastic surgery Medicine-Surgery
CiteScore
1.70
自引率
0.00%
发文量
73
期刊介绍: Plastic Surgery (Chirurgie Plastique) is the official journal of the Canadian Society of Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery, Group for the Advancement of Microsurgery, and the Canadian Society for Surgery of the Hand. It serves as a major venue for Canadian research, society guidelines, and continuing medical education.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信