Experiences with Surgical Reconstruction of Penoscrotal Extramammary Paget's Disease: A review of 21 cases
| Autor: | Jinming Zhang, Jiaqi Zhang, Zheng Su, Xiaolian Xiao, Weiqiang Liang, Meng Liu, Jian Zhang |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Extramammary Paget's disease Surgical Flaps Lesion 030207 dermatology & venereal diseases 03 medical and health sciences Postoperative Complications 0302 clinical medicine Scrotum medicine Frozen Sections Humans In patient Penile Neoplasms Pathological Aged Retrospective Studies Wound Healing Frozen section procedure integumentary system Wound dehiscence business.industry Middle Aged medicine.disease Surgery Paget Disease Extramammary medicine.anatomical_structure 030220 oncology & carcinogenesis Neoplasm Recurrence Local medicine.symptom business Penis |
| Zdroj: | Journal of Plastic, Reconstructive & Aesthetic Surgery. 73:1700-1705 |
| ISSN: | 1748-6815 |
| Popis: | Summary Background Penoscrotal extramammary Paget's disease is a rarely found intraepithelial adenocarcinoma in older male patients. The challenge for surgeons to perform high-quality post-surgery reconstruction is mostly case-dependent. Here, we present a review of post-surgical reconstruction practice in 21 cases using various scrotal skin flaps. Methods During the 10-year study period (from 2008 to 2018), all 21 male patients diagnosed with penoscrotal extramammary Paget's diseases at Sun Yat-sen memorial hospital were enrolled in this study. All patients underwent expanding resections guided by frozen sections and penoscrotal reconstructions using various scrotal skin flaps alone or combined with pubic skin flaps and partial thickness skin graft depending on individual defects. The patient's clinical data, specifically the diagnosis, surgical outcome, and follow-up evaluation were retrospectively analyzed. Results The size of skin lesions ranged from 4 × 5 cm to 16 × 18 cm approximately. Out of 21 total cases, 13 patients received combined scrotal and pubic flaps, three patients received single scrotal flaps, and five patients received scrotal flaps and partial thickness skin grafts. Limited flap tip necrosis (two cases) and wound dehiscence (one case) were observed, and secondary resections were performed in four cases with positive post-operative pathological results. All patients experienced complete wound healing and had well-maintained penile morphology and function. Conclusion Various scrotal skin flaps alone or combined with pubic skin flaps designed for individual lesion conditions in patients with penoscrotal extramammary Paget's disease are efficient for scrotal reconstruction. A good match of the local skin texture helps to maintain the morphology and function of the penis and scrotum. |
| Databáze: | OpenAIRE |
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