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马外生殖器鳞状细胞癌:阴茎截肢术和尿道造口术作为手术治疗方法的综述与评估

Squamous cell carcinoma of the equine external genitalia: a review and assessment of penile amputation and urethrostomy as a surgical treatment.

作者信息

Howarth S, Lucke V M, Pearson H

机构信息

Department of Veterinary Surgery, University of Bristol, School of Veterinary Science, Langford, UK.

出版信息

Equine Vet J. 1991 Jan;23(1):53-8. doi: 10.1111/j.2042-3306.1991.tb02715.x.

Abstract

A retrospective analysis was performed on 48 cases of suspected neoplasia involving the equine external genitalia. Forty nine squamous cell carcinomata (SCC) and 23 squamous papillomata (SP) were identified. Two cases of epithelial hyperplasia and one case of habronemiasis were also recognised histopathologically. The glans penis was the most common site of tumour development accounting for 53 per cent of cases of SCC and 61 per cent of SP. The urethral diverticulum, urethral process or urethra was involved in 27.6 per cent (8/29) of cases of SCC. Twelve per cent (5/41) of cases of SCC were confirmed to have metastatic involvement of the local lymph nodes. Papillomata showing pre-malignant changes were identified in five cases. Seventy five per cent (36/48) of the animals presented were ponies. All were geldings, mean age 16.5 years. Penile amputation and urethrostomy, preputial ablation and proximal urethrostomy or local excision were used in the surgical management of these animals; three cases were inoperable and destroyed at presentation. Oedema, haemorrhage and stenosis of the urethrostomy site were encountered as post operative complications. Sixty six per cent (6/9) of animals with SCC of the glans penis (without urethral involvement), which had a known history over the follow up period, treated by penile amputation and urethrostomy survived for longer than 18 months. Similarly, of those with urethral involvement only 28.6 per cent (2/7) survived for a similar follow-up period. SCC not uncommonly affects the external genitalia of aged pony geldings and frequently the glans penis. If the lesion is identified before local metastasis occurs, penile amputation and urethrostomy is indicated and the prognosis is favourable.

摘要

对48例疑似马外生殖器肿瘤的病例进行了回顾性分析。共识别出49例鳞状细胞癌(SCC)和23例鳞状乳头瘤(SP)。组织病理学检查还发现2例上皮增生和1例柔线虫病。阴茎头是肿瘤发生最常见的部位,占SCC病例的53%,SP病例的61%。27.6%(8/29)的SCC病例累及尿道憩室、尿道突或尿道。12%(5/41)的SCC病例证实有局部淋巴结转移。5例乳头瘤出现了癌前病变。所呈现的动物中有75%(36/48)是小马。均为去势公马,平均年龄16.5岁。这些动物的手术治疗采用阴茎截肢术和尿道造口术、包皮切除术和近端尿道造口术或局部切除术;3例在就诊时无法手术而被安乐死。术后并发症包括尿道造口部位的水肿、出血和狭窄。阴茎头SCC(无尿道受累)且在随访期有已知病史的动物中,66%(6/9)接受阴茎截肢术和尿道造口术治疗后存活超过18个月。同样,仅累及尿道的动物中,只有28.6%(2/7)在类似的随访期内存活。SCC常影响老年小马去势公马的外生殖器,且常累及阴茎头。如果在局部转移发生前识别出病变,应行阴茎截肢术和尿道造口术,预后良好。

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