Division of Urology, ABC Medical School, Sao Paulo, SP, Brazil.
Int Braz J Urol. 2010 Mar-Apr;36(2):198-201; discussion 201. doi: 10.1590/s1677-55382010000200010.
Penile carcinoma is a rare but mutilating malignancy. In this context, partial penectomy is the most commonly applied approach for best oncological results. We herein propose a simple modification of the classic technique of partial penectomy, for better cosmetic and functional results.
If partial penectomy is indicated, the present technique can bring additional benefits. Different from classical technique, the urethra is spatulated only ventrally. An inverted "V" skin flap with 0.5 cm of extension is sectioned ventrally. The suture is performed with vicryl 4-0 in a "parachute" fashion, beginning from the ventral portion of the urethra and the "V" flap, followed by the "V" flap angles and than by the dorsal portion of the penis. After completion of the suture, a Foley catheter and light dressing are placed for 24 hours.
Several complex reconstructive techniques have been previously proposed, but normally require specific surgical abilities, adequate patient selection and staged procedures. We believe that these reconstructive techniques are very useful in some specific subsets of patients. However, the technique herein proposed is a simple alternative that can be applied to all men after a partial penectomy, and takes the same amount of time as that in the classic technique. In conclusion, the "parachute" technique for penile reconstruction after partial amputation not only improves the appearance of the penis, but also maintains an adequate function.
阴茎癌是一种罕见但破坏性极大的恶性肿瘤。在这种情况下，部分阴茎切除术是获得最佳肿瘤学结果的最常用方法。在此，我们提出了一种简单的部分阴茎切除术的改良方法，以获得更好的美容和功能效果。
如果需要进行部分阴茎切除术，目前的技术可以带来额外的好处。与经典技术不同，尿道仅在腹侧进行翼状切开。在腹侧切开一个带有 0.5 厘米延伸的倒“V”形皮瓣。用 4-0 薇乔缝线以“降落伞”的方式进行缝合，从尿道的腹侧部分和“V”形皮瓣开始，然后是“V”形皮瓣的角度，最后是阴茎的背侧部分。完成缝合后，放置 Foley 导管和轻便敷料 24 小时。
先前已经提出了几种复杂的重建技术，但通常需要特定的手术能力、适当的患者选择和分期手术。我们认为，这些重建技术在某些特定的患者亚组中非常有用。然而，我们提出的这种技术是一种简单的替代方法，可以应用于所有接受部分阴茎切除术的男性，并且与经典技术所需的时间相同。总之，部分阴茎切除术后采用“降落伞”技术进行阴茎重建不仅可以改善阴茎的外观，还可以保持足够的功能。
