Marque M, Chartier R, Donette I, Assaf N, Dast S, Sinna R
Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France.
Service de chirurgie plastique reconstructrice et esthétique, CHU d'Amiens Picardie, Rond-point Pr Cabrol, 80054 Amiens cedex 1, France.
Ann Chir Plast Esthet. 2023 Aug;68(4):378-384. doi: 10.1016/j.anplas.2023.01.003. Epub 2023 Feb 16.
This article deals with a clinical case of a tube in a tube TDAP phalloplasty in a 38 years old trans-man. While penis reconstruction surgery aroused an efflorescence of different operative techniques, the resulting female to male surgery sees these procedures boil down to two or three flaps. If we usually discuss before surgery about the way to lengthen the urinary tract, as the way to implant later for intercourse; the choice of the donor site remains too systematized. Surgeons commonly focus on the reconstructed site prior to the donor site. In this case, laxity in the back and reliability of direct closure make us harvest the thoracodorsal perforator flap. Dissection of perforators saves muscular function and direct closure afford an aesthetic result less visible than a graft on the forearm. The thin flap we harvest allows tube in tube phalloplasty so that phallus and urethra are being built in the same time. One case has been reported in the literature of thoracodorsal perforator flap phalloplasty with grafted urethra, but no case of tube within a tube TDAP phalloplasty.
本文介绍了一名38岁跨性别男性进行管中管横向腹直肌肌皮瓣阴茎再造术的临床病例。虽然阴茎重建手术引发了各种手术技术的兴起，但由此产生的女性变男性手术可归结为两三种皮瓣手术。通常在手术前，我们会讨论延长尿道的方法，以及之后植入用于性交的方式；但供区的选择仍然过于模式化。外科医生通常在考虑供区之前先关注重建部位。在这个病例中，背部的松弛度以及直接缝合的可靠性使我们采用了胸背穿支皮瓣。穿支的解剖保留了肌肉功能，直接缝合所获得的美学效果比在前臂进行移植更不易被察觉。我们获取的薄皮瓣可用于管中管阴茎再造术，从而使阴茎和尿道同时构建。文献中曾报道过使用移植尿道的胸背穿支皮瓣阴茎再造术，但没有管中管横向腹直肌肌皮瓣阴茎再造术的病例。
