Hasegawa Kenjiro, Namba Yuzaburo, Kimata Yoshihiro
Department of Plastic and Reconstractive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,
Acta Med Okayama. 2014;68(3):183-90. doi: 10.18926/AMO/52660.
Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. As compared to a forearm flap, use of an innervated island-pedicled flap may have the following advantages in phalloplasty: 1) no need for a microsurgical technique; 2) no scars at noticeable sites; 3) small functional loss in the flap donor area; 4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction.
自2001年以来，我们一直采用游离桡侧前臂皮瓣进行阴茎成形术，将其作为女变男易性症患者（FTMTS）的首选皮瓣。在本病例中，一名22岁的FTMTS患者艾伦试验结果为阴性，我们采用“管中管”技术，使用带神经的岛状蒂股前外侧皮瓣进行阴茎成形术，取得了良好效果，其中阴茎和尿道由单一皮瓣构建。与前臂皮瓣相比，在阴茎成形术中使用带神经的岛状蒂皮瓣可能具有以下优点：1）无需显微外科技术；2）在显眼部位无瘢痕；3）皮瓣供区功能损失小；4）不牺牲主要血管。因此，该技术似乎是阴茎重建的一种有用的临床替代方法。
