30 Years of Experience in Musculocutaneous Latissimus Dorsi Flap Phalloplasty with Reinnervation: Optimal Principles.
| Autor: | Adamyan RT; Department of Plastic Surgery, Yerevan State Medical University, Yerevan, Armenia., Startseva OI; Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russian Federation., Gabriyanchik MA; Department of Oncology, Radiotherapy and Plastic Surgery, Sechenov University, Moscow, Russian Federation. |
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| Jazyk: | angličtina |
| Zdroj: | Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Apr 26; Vol. 11 (4), pp. e4963. Date of Electronic Publication: 2023 Apr 26 (Print Publication: 2023). |
| DOI: | 10.1097/GOX.0000000000004963 |
| Abstrakt: | The technique of urogenital plastic surgery continues to pose difficulties for surgeons due to physical features of the anatomical region, which complicates the correction of various severe male urogenital pathologies. The goal of the surgeon is to create a neophallus that allows for urination and intercourse with minimal damage to the donor site. This special topic provides a historical overview and principles for optimal phalloplasty. To improve results in latissimus dorsi free-flap phalloplasty, we share our approach, its benefits, and the lessons we have learned. Methods: We performed a retrospective review of patients who underwent shaft-only, two-stage or one-stage latissimus dorsi flap phalloplasty with or without reinnervation at a single institution from 1991 through 2020. Patients with a minimum of 1 year of follow-up were included. Data on the patient's demographics, the procedure, and the results of the operation were maintained. Results: In total, 592 latissimus dorsi flap phalloplasties were performed during the entire study period. Of the phalloplasties, 494 (83.5%) were performed for gender-affirming surgery, of which 470 were performed for transgender patients and 24 for intersex patients. Twenty-five patients (4.2%) had congenital malformations, 17 (2.9%) had oncologic resections, and 56 had posttraumatic loss (9.5%). Conclusion: Latissimus dorsi flap total phalloplasty with reinnervation is currently one of the few methods that can solve not only an aesthetic problem, but also a functional one without the use of an endoprosthesis if the level of reinnervation and muscle contraction is sufficient. Competing Interests: The authors have no financial interests to declare in relation to the content of this article. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.) |
| Databáze: | MEDLINE |
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