阴茎阴囊Paget病局部扩大切除术与根治性切除术的比较研究

发布时间：2018-12-24 06:57

【摘要】：目的通过与根治性切除术比较,评价阴茎阴囊Paget病局部扩大切除术的疗效。方法回顾性分析2010年11月—2015年8月收治并符合选择标准的41例阴茎阴囊Paget病患者临床资料,其中14例采用局部扩大切除术(A组),27例采用根治性切除术(B组)。两组患者年龄、病程、病损部位等一般资料比较,差异均无统计学意义(P0.05),具有可比性。记录并比较两组复发率、手术时间、术中快速冰冻病理检查次数、术后住院时间、创面愈合分级、患者功能及外观自评满意度评分。结果与B组比较,A组手术时间、术后住院时间均显著缩短,术中快速冰冻病理检查次数减少,比较差异均有统计学意义(P0.05)。两组患者均获随访,A组随访时间为13~67个月,平均35.5个月;B组11~70个月,平均38.8个月。A组创面甲级愈合11例、乙级愈合2例、丙级愈合1例,B组分别为12、7、8例,两组比较差异有统计学意义(Z= 2.102,P=0.036)。术后5年内A组复发4例(28.6%),B组复发6例(22.2%),比较差异无统计学意义(χ2=0.202,P=0.654)。末次随访时,A组患者外观及功能自评满意度评分显著高于B组,比较差异有统计学意义(t= 2.810,P=0.008)。结论阴茎阴囊Paget病进展缓慢,预后良好,局部扩大切除术可有效去除症状,降低老年患者围手术期风险,且术后复发率较根治性切除术未明显升高。
[Abstract]:Objective to evaluate the effect of local extended excision of Paget's disease of penis and scrotum by comparing with radical excision. Methods the clinical data of 41 patients with Paget's disease of penis and scrotum admitted from November 2010 to August 2015 were retrospectively analyzed. Among them, 14 cases were treated with local extended excision (group A) and 27 cases with radical resection (group B). There was no significant difference between the two groups in age, course of disease, lesion location and other general data (P0.05). The recurrence rate, operation time, the times of intraoperative frozen pathological examination, postoperative hospitalization time, wound healing grade, self-evaluation satisfaction score of patients' function and appearance were recorded and compared between the two groups. Results compared with group B, the operation time and postoperative hospitalization time of group A were significantly shortened, and the number of intraoperative rapid frozen pathological examination was decreased, the difference was statistically significant (P0.05). Two groups of patients were followed up. Group A was followed up for 13 ~ 67 months with an average of 35.5 months. There were 11 cases of grade A wound healing, 2 cases of grade B healing, 1 case of grade C healing in group B and 8 cases in group B, respectively. The difference between the two groups was statistically significant (Z = 2.102). Within 5 years after operation, 4 cases (28.6%) recurred in), B group (22.2%), there was no significant difference between them (蠂 ~ 2 / 0.202 P ~ (0.654). At the last follow-up, the scores of self-evaluation satisfaction of appearance and function in group A were significantly higher than those in group B (t = 2.810p 0.008). Conclusion Paget's disease of penis scrotum develops slowly and has a good prognosis. Extended local excision can effectively remove symptoms and reduce perioperative risk in elderly patients, and the recurrence rate is not significantly higher than that of radical excision.
【作者单位】：四川大学华西医院美容整形-烧伤外科;
【分类号】：R699.8

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