Application of scrotal flap in the excision and repair of penoscrotal Paget disease
10.3760/cma.j.cn114453-20190701-00207
- VernacularTitle:阴囊皮瓣在阴茎阴囊Paget病切除修复中的应用
- Author:
Jian ZHANG
1
;
Weiqiang LIANG
;
Jinming ZHANG
;
Jiaqi ZHANG
;
Xiaolian XIAO
;
Zheng SU
;
Meng LIU
Author Information
1. 中山大学孙逸仙纪念医院整形外科，广州 510000
- Keywords:
Paget disease, extramammary;
Reconstructive surgical procedures;
Surgical flaps;
Penis;
Scrotum
- From:
Chinese Journal of Plastic Surgery
2021;37(3):281-288
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the method, feasibility and clinical effect of scrotal flap in the immediate repair of penoscrotal Paget disease after excision.Methods:From January 2008 to September 2018, a total of 21 patients (age 42-74) diagnosed with penile scrotal Paget disease were admitted and treated in our department. All patients underwent local expanded resection, and intraoperative frozen section examination confirmed a negative margin. All patients used the scrotal flap or scrotal flap combined with other surgical methods to repair the defect.Results:Scrotal flaps were used in ten cases, scrotal flaps combined with other flaps in seven cases, and scrotal flaps combined with skin grafting in four cases. All the scrotal flaps had good blood supply, two cases had small partial skin graft necrosis, and one case had delayed healing of the flap donor area, and all the others had good wound healing. All patients were followed up for six months to 60 months, with an average follow-up time of 30.6 months. Most of the patients (95.2%, 20/21) were satisfied with the appearance of the penis and scrotum, and all the transferred flaps showed no edema. Local recurrence occurred in four patients within two years. Local recurrence and inguinal lymph node metastasis occurred in one patient within three years with a total local recurrence rate of 23.8% (5/21). Due to the small local recurrence lesion, the recurrence lesion was successfully repaired with the adjacent scrotal flap after expanding local excision, and the patients with inguinal lymph node metastasis received ipsilateral inguinal lymph node dissection.Conclusions:The scrotal flap has the characteristics of a large cutting area, flexible design, convenient transfer of flap, enough blood supply, simple, safe, and effective. Using this method can obtain a satisfactory shape of the penis and scrotum after the operation. Those defects that are difficult to use scrotal flap for a complete repair can be repaired with other flaps or skin grafts. A good therapeutic effect can be obtained as well. For the majority of recurrent lesions, scrotal skin flap can be reapplied.
