成功的显微外科阴茎截肢再植术:病例报告和文献综述。

IF 0.9 Q3 SURGERY World Journal of Plastic Surgery Pub Date : 2023-01-01 DOI:10.61186/wjps.12.3.18
Mohammad-Reza Akhoondinasab, Hamid-Reza Farahmand, Afshin Zahedi, Amir Saraee
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引用次数: 0

摘要

本研究旨在解释一例罕见的长期缺血后阴茎完全切除的显微再植手术。一名 36 岁的患者在 9 小时后接受了阴茎显微再植术。患者的阴茎因自残而完全截断。术前准备后进行了显微血管再植术。术后第二天,观察到阴茎充血,进行了三次水蛭疗法,每次放置水蛭 30 分钟,然后自行脱落。出院后,患者被转诊至精神科医生处继续治疗。阴茎截肢是一种罕见的情况,其原因各不相同。修复截断阴茎的治疗方法有很多种,既有显微手术,也有微血管手术。显微外科方法效果最好。在本病例中,由于采用了显微外科动脉修复术,并及早开始了水蛭疗法,阴茎阴囊交界皮瓣区域出现了有限的、可预见的坏死,进行了清创和植皮。阴茎完全切除是一种罕见的现象。应努力尽快进行再植手术。静脉流出是阴茎再植手术成功的关键因素,在本病例中,静脉流出完全恢复了血管和感觉功能。及早开展心理护理以控制潜在疾病,可促使患者进一步配合处理并发症,避免再次发生自残行为。
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Successful Microsurgical Replantation of Amputated Penis: A Case Report and Review of Literature.

This study aims to explain microscopic replantation in a rare case of a wholly amputated penis after prolonged ischemia. A 36-year-old patient underwent microscopic replantation of the penis after 9 hours. The penis was completely amputated due to self-mutilation. Microvascular replantation was performed after pre-operative preparation. On the second day after surgery, congestion was observed in the penis, and three sessions of leech therapy were conducted each time the leeches were placed for 30 minutes and then detached by themselves. The patient was referred to a psychiatrist to continue treatment after discharge from the hospital. Penile amputation is a rare situation and has different causes. There are various treatments to repair the amputated penis, which are both microvascular and microvascular. The microsurgery methods have shown the best results. In the present case, due to microsurgical artery repair and the early start of leech therapy, there was limited and predictable necrosis in the area of the penoscrotal junction flap, which underwent debridement and skin graft. Complete amputation of the penis is a rare phenomenon. Efforts should be made to perform the replantation surgery as soon as possible. The venous outflow is an essential factor in the success of penile re-implantation, and completely restored vascular and sensory function in this case. Early initiation of psychological care to control underlying disease leads to further cooperation of the patient to handle complications and avoid the recurrence of self-injury.

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