Total Resurfacing of the Penis for Penopubic Extramammary Paget's Disease with Split-Thickness Skin Graft

以全補皮手術治療陰莖恥部Extramammary Paget's Disease

陳柄仁(Bing-Ren Chen) ； 楊振(Chen Yang) ； 李宗瀚(Tzong-Hann Lee)

《中華民國整形外科醫學會雜誌》 14卷2期 (2005/06) Pp. 153-161

https://doi.org/10.7096/JPSA.200506.0153

摘要

發生在陰莖恥部的Extramammary Paget's Disease (EMPD)是不常見的，它是一種皮膚癌變的疾病，甚至有遠處轉移的可能。本篇目的在描述我們治療陰莖恥部EMPD的外科手術技巧。從1999年12月至2003年3月，共有三位這樣的病人，都有皮膚切片檢查證實，他們已在皮膚科或放射科治療一段時間後轉到本科。我們採用手術方式治療，將陰莖恥部患處皮膚全部去除，包括外圍一公分正常皮膚及陰莖所有皮膚，再用植皮方式覆蓋傷口。手術結果皮膚移植存活率100%，陰莖功能良好，外型美觀。依這樣的手術方式，不會發生像陰莖局部補皮所引起的陰莖水腫；也不會像補皮瓣那樣變得很肥大。三位病患分別在1.5至3年追蹤下，沒有復發現像。總括而論：陰莖恥部全補皮手術對EMPD來說，是種有價值之治療方式，它不僅美觀、技巧簡單、功能全保留，甚至是根除此病，讓它不會在陰莖復發。

並列摘要

Extramammary Paget's disease (EMPD) confined to the penopubis is not common. It's a pre-malignant skin lesion and has the possibility of distant metastasis. This study described a surgical technique for the treatment of EMPD of the penopubis. Between December, 1999 and March, 2002, three patients with penopubis EMPD was proved by skin biopsy after a long period of multimodality treatment given by the dermatologist and the radiologist. All patient underwent a STSG total resurfacing operation at the whole penopubis following wide local excision with 1cm safety margin. Graft survival was 100 percent. Functional and cosmetic result is excellent. In our experience, there was no penis lymphoedema occurring after proximal penis STSG and no bulk penis resulting from flap reconstruction. All patients were disease free after 1.5 to 3 years follow-up. In conclusion, the STSG total resurfacing of the penopubis EMPD is a valuable option. It carried an excellent appearance, it is technically simple, the functional result is preserved, and it seems devoid the possibility of recurrence of the penile skin.

並列關鍵字

extramammary Paget's disease EMPD ； penopubis EMPD ； split skin graft