改良Brisson术联合阴茎周围脂肪剔除术治疗肥胖儿童隐匿性阴茎的临床研究

doi:10.3969/j.issn.1009-976X.2022.03.012

摘要/Abstract

摘要： 目的改良Brisson术联合阴茎周围脂肪剔除术治疗肥胖儿童隐匿性阴茎的临床效果。方法回顾分析我院2018年1月至2021年1月124例隐匿性阴茎（CP）肥胖儿童的临床资料,根据手术方法分为观察组（n=84）及对照组（n=40）,对照组采用改良Brisson术治疗,观察组采用改良Brisson术联合阴茎周围脂肪剔除术治疗。比较两组手术相关指标、手术前后生活质量、患儿家属对阴茎显露满意度、术后并发症。结果观察组术后阴茎长度、手术时间、术后阴茎显露长度、术后阴茎长度/术前阴茎长度、术后阴茎显露长度/术前阴茎长度均高于对照组（P<0.05）;观察组术后生活便利性、躯体感受、负性情绪、自我概念、同伴关系及自我满意度等维度评分均高于对照组（P<0.05）;观察组患儿家长满意度为94.04%高于对照组77.50%（P<0.05）;观察组患儿术后并发症的发生率为7.14%低于对照组20.00%（P<0.05）。结论改良Brisson术联合阴茎周围脂肪剔除术治疗肥胖CP儿童的效果良好,能有效促进阴茎外观恢复正常形态,改善患儿生活质量、提高患儿家属满意度,减少并发症。

关键词: 肥胖儿童, 隐匿性阴茎, 改良Brisson术, 脂肪剔除术

Abstract: Objective To explore the clinical curative effect of modified Brisson's surgery combined with peri-penile liposuction on concealed penis （CP） in obese children. Methods A retrospective analysis was performed on the clinical data of 124 obese children with CP in the hospital between January 2018 and January 2021. According to different surgical methods, they were divided into observation group （n=84, modified Brisson's surgery combined with peri-penile liposuction） and control group （n=40, modified Brisson's surgery）. The surgical relatedindexes, quality of life before and after surgery, satisfaction of their family members with penis exposure, and postoperative complications were compared between the two groups. Results After surgery, length of penis,operation time, length of penis exposure, postoperative/preoperative length of penis and postoperative/preoperative length of penis exposure in observation group were significantly higher than those in control group （P<0.05）. After surgery, scores of life convenience, physical sensation, negative emotions, self-concept, peer relationship and self-satisfaction in observation group were higher than those in control group （P<0.05）. The parental satisfaction rate in observation group was higher than that in control group （94.04% vs 77.50）（P<0.05）, and incidence of postoperative complications was lower than that in control group （7.14% vs 20.00%）（P<0.05）. Conclusion The curative effect of modified Brisson's surgery combined with peri-penile liposuction is good on obese children with CP, which can effectively promote the recovery of normal penis shape, improve children' quality of life and satisfaction of their family members, and reduce complications.

Key words: obese child, concealed penis, modified Brisson's surgery, liposuction

中图分类号:

R699.8

夏凡, 章奇, 周高熙, 周维. 改良Brisson术联合阴茎周围脂肪剔除术治疗肥胖儿童隐匿性阴茎的临床研究[J]. 岭南现代临床外科, 2022, 22(03): 276-279.

XIA Fan, ZHANG Qi, ZHOU Gao-xi, ZHOU Wei. Clinical study of modified Brisson's surgery combined with peri-penile liposuction in the treatment of concealed penis in obese children[J]. Lingnan Modern Clinics In Surgery, 2022, 22(03): 276-279.

参考文献

[1] Ergashev K, Chung JM, Lee SD.Concealed index for concealed penis in prepubertal children[J]. InvestigClin Urol, 2021, 62(2):217-223.
[2] 井颖, 张振山, 潮敏. 包皮脱套松解延长固定术治疗对隐匿性阴茎患儿阴茎疲软时显露长度的影响[J]. 中国性科学, 2021, 30(10):14-17.
[3] 胡耀宗, 徐冰, 蔡宝, 等. 改良Borsellino术式治疗儿童隐匿阴茎的疗效观察[J]. 中华小儿外科杂志, 2021, 42(5):435-438.
[4] 李昌佩, 周维, 夏凡, 等. “双针法”在小儿隐匿性阴茎矫正手术的应用[J]. 中国现代手术学杂志, 2020, 24(5):374-378.
[5] 王誉都, 李鹏, 高亚, 等. 改良Devine术治疗小儿隐匿性阴茎对患儿术后阴茎长度和生长发育的影响[J]. 国际泌尿系统杂志, 2020, 40(1):99-102.
[6] Li G, Mao J, Yang D, et al.A new technique for correction of the concealed penis in children: Step-by-Step technique and 1-5 year outcomes[J]. Asian J Surg, 2020, 43(8):845-846.
[7] 李灵, 蒋爱民, 向慧, 等. Devine术和改良Brisson术治疗儿童隐匿性阴茎的比较[J]. 微创泌尿外科杂志, 2021, 10(5):335-338.
[8] 毛金水,刘毅东,王颖斌,等.三种缝合线对隐匿性阴茎包皮脱套根部固定术后生活质量和复发率的影响[J].中华整形外科杂志,2016,32(6):425-428.
[9] 中华医学会男科学分会. 儿童隐匿性阴茎诊治的中国专家共识[J]. 中华男科学杂志, 2021, 27(10):941-947.
[10] Caione P, Cavaleri Y, Gerocarni Nappo S, et al.The concealed penis: the “two-corner” surgical technique[J]. Minerva Urol Nephrol, 2021, 73(1):122-127.
[11] Shalaby M, Cascio S.Megaprepuce: a systematic review of a rare condition with a controversial surgical management[J]. Pediatr Surg Int, 2021, 37(6):815-825.
[12] Staniorski CJ, Rusilko PJ.The concealed morbidity of buried penis: a narrative review of our progress in understanding adult-acquired buried penis as a surgical condition[J]. Transl Androl Urol, 2021, 10(6):2536-2543.
[13] Zhang H, Zhao G, Feng G, et al.A new surgical technique for the treatment of congenital concealed penis based on anatomical finding[J]. J Urol, 2020, 204(6):1341-1348.
[14] Özkidik M, Telli O, Hamidi N, et al.Concealed penis after circumcision: is it beneficial in lowering uropathogenic colonization in penile skin and preventing recurrence of febrile urinary tract infections[J]. Urol J, 2020, 17(2):164-168.
[15] 张林琳, 李博伦, 范晋海, 等. 内外板单瓣嵌插术与改良Brisson术治疗隐匿型阴茎的临床疗效及安全性[J]. 现代生物医学进展, 2020, 20(3):502-505+487.
[16] Ngaage LM, Lopez J, Wu Y, et al.Uncovering the hidden penis: a nomenclature and classification system[J]. Ann Plast Surg, 2021, 86(4):444-449.
[17] 杨俊家,王爱和,杨华军,等.不同手术方法治疗小儿隐匿性阴茎的临床效果分析[J].中国妇幼保健,2020,35(6):1073-1075.