上腹部皮瓣或脐旁皮瓣联合肋缘软骨瓣阴茎再造--一个新术式的解剖学研究

目的 :为一期行阴茎再造解决支撑体的血运问题提供解剖依据。方法 :选用 30侧成人防腐固定标本 ,对腹壁上、下血管及肋缘软骨的血供来源、走行、分布及它们的吻合关系进行了详细解剖学观测。结果 :肋缘软骨的血供主要来源于腹壁上和第 8肋间血管的肋缘骨膜支和直接骨膜支 ;上腹部或脐旁皮瓣血供来源于腹壁上、下血管的穿支 ;腹壁上、下血管之间在脐上存在吻合弓 ;腹壁下血管起点至脐距离12cm ,而至耻骨联合距离 9cm ,蒂长 ,直径粗。结论 :可以形成以腹壁下血管为蒂的上腹部或脐旁皮瓣联合血管化的肋缘软骨瓣转移一期阴茎再造。

Upper abdominal or paraumbilical flap combined with vascularized costal cartilage for penis reconstruction in one-stage(an anatomical study)

Objective:To provide the anatomical basis of the penis reconstruction in one stage.Methods:Origin,distribution and anastomosis of superior,inferior epigastric artery and the blood supply of costal cartilage were observed in 30 cases adult cadaver specimens.Results:The blood supply of costal cartilage comes from the superior epigastric artery and the eighth intercostal artery,and the blood supply of upper abdominal or paraumbilical flap come from muculocutaneous or paraumbilical perforator of the inferior epigastric vessel.There exist an anatomosis zone between the superior and inferior epigastrc artery above umbilical area.Conclusion:Upper abdominal or paraumbilical flap combined with vascularized costal cartilage for penis recontruction in one stage can be designed.