Penile Reconstruction: Is the Radial Forearm Flap Really the Standard Technique?
Penile Reconstruction: Is the Radial Forearm Flap Really the Standard Technique?
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DOI：
10.1097/prs.0b013e3181aeeb06
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发表时间：
2009-08-01
影响因子：
3.6
通讯作者：
De Cuypere, Griet
中科院分区：
文献类型：
--
作者：
Monstrey, Stan;Hoebeke, Piet;De Cuypere, Griet
背景资料：阴茎再造的理想目标已经被很好地描述了，但是阴茎成形术中使用的大量皮瓣只是表明这些技术中没有一种被认为是理想的。尽管如此，桡侧前臂皮瓣是最常用的皮瓣和普遍认为是标准technique.Methods：在这篇文章中，作者描述了最大的系列，到目前为止的287桡侧前臂阴茎成形术由同一个手术团队。许多不同的结果参数已分别在以前发表的文章中描述，但本综述的主要目的是批判性地评估在何种程度上这种所谓的标准技术已经能够满足阴茎重建的理想目标。结果：结果参数，如手术次数、并发症、美学结果、触觉和性感觉、排尿、供体部位发病率、阴囊成形术，结论：在缺乏前瞻性随机研究的情况下，不可能证明前臂桡侧皮瓣是否真的是阴茎再造的标准技术。然而，这项大型研究表明，桡侧前臂阴茎成形术是一种非常可靠的技术，主要分两个阶段，创造一个正常外观的阴茎和阴囊，总是允许患者在站立时排尿，在大多数情况下也能体验到性满足。该技术的相对缺点是初始瘘的数量相当高，前臂上的残留疤痕，以及潜在的长期泌尿系统并发症。尽管缺乏实际数据支持这一说法，但作者强烈认为，重建/整形外科医生和泌尿科医生之间密切合作的多学科方法是获得最佳结果的绝对必要条件。（Plast。重建124：510，2009）。
Background: The ideal goals in penile reconstruction are well described, but the multitude of flaps used for phalloplasty only demonstrates that none of these techniques is considered ideal. Still, the radial forearm flap is the most frequently used flap and universally considered as the standard technique.Methods: In this article, the authors describe the largest series to date of 287 radial forearm phalloplasties performed by the same surgical team. Many different outcome parameters have been described separately in previously published articles, but the main purpose of this review is to critically evaluate to what degree this supposed standard technique has been able to meet the ideal goals in penile reconstruction.Results: Outcome parameters such as number of procedures, complications, aesthetic outcome, tactile and erogenous sensation, voiding, donor-site morbidity, scrotoplasty, and sexual intercourse are assessed.Conclusions: In the absence of prospective randomized studies, it is not possible to prove whether the radial forearm flap truly is the standard technique in penile reconstruction. However, this large study demonstrates that the radial forearm phalloplasty is a very reliable technique for the creation, mostly in two stages, of a normal-appearing penis and scrotum, always allowing the patient to void while standing and in most cases also to experience sexual satisfaction. The relative disadvantages of this technique are the rather high number of initial fistulas, the residual scar on the forearm, and the potential long-term urologic complications. Despite the lack of actual data to support this statement, the authors feel strongly that a multidisciplinary approach with close cooperation between the reconstructive/plastic surgeon and the urologist is an absolute requisite for obtaining the best possible results. ( Plast. Reconstr. Surg. 124: 510, 2009.)