Licht M R, Lewis R W
Department of Urology, Cleveland Clinic Florida, Ft. Lauderdale, USA.
J Urol. 1997 Aug;158(2):460-3.
We describe a surgical modification of the Nesbit procedure to correct Peyronie's disease, and compare the results of this procedure with those of 2 other surgical techniques.
In 30 patients a vertical incision in the tunica albuginea was closed in a horizontal fashion with permanent suture knots buried beneath the tunica in a running looped fashion, resulting in watertight closure with no exposed suture material. A standard Nesbit procedure and plaque excision with a polyethylene terephthalate mesh reinforced silicone sheet patch graft were done in 28 cases each.
Elimination of penile curvature, patient satisfaction and postoperative impotence rates were not statistically different for standard and modified Nesbit procedures. However, plaque excision and synthetic patch grafting resulted in less elimination of curvature (61%, p = 0.004), a lower rate of satisfaction (30%, p = 0.00002) and a higher incidence of impotence after surgery (18%, p = 0.04). The modified Nesbit procedure achieved an overall higher rate of correction of curvature than the standard approach (93 versus 79%).
A modified Nesbit procedure achieves the greatest functional success for Peyronie's disease with an acceptably low complication rate.
我们描述一种用于矫正佩罗尼氏病的Nesbit手术改良方法，并将该手术结果与其他两种手术技术的结果进行比较。
对30例患者，白膜上的垂直切口以水平方式闭合，用永久缝线结以连续环行方式埋于白膜下方，实现水密性闭合且无外露缝线材料。分别对28例患者进行标准Nesbit手术以及用聚对苯二甲酸乙二酯网加强硅胶片修补片进行斑块切除术。
标准Nesbit手术和改良Nesbit手术在消除阴茎弯曲、患者满意度和术后阳痿发生率方面无统计学差异。然而，斑块切除和合成修补片移植在消除弯曲方面效果较差（61%，p = 0.004），满意度较低（30%，p = 0.00002），术后阳痿发生率较高（18%，p = 0.04）。改良Nesbit手术比标准手术总体上矫正弯曲的比例更高（93%对79%）。
改良Nesbit手术对佩罗尼氏病取得了最大的功能成功，且并发症发生率可接受地低。
