摘要：阴茎癌是一种罕见的肿瘤，发病率约为 0.006 6‰~0.014 4‰，死亡率约为 0.015‰~0.037‰。通过体格 检查和组织学活检确定病灶范围和侵袭程度对制定适当的治疗方案较为重要。局部阴茎癌的治疗可分为原发肿瘤 治疗和区域淋巴结治疗。本文将重点关注原发性阴茎肿瘤治疗，着重阐述常见的阴茎保留术式。原发性阴茎癌治 疗的目的为完全切除肿瘤，同时尽可能地保留器官功能。阴茎保留对患者十分重要，可提升患者的排尿功能、性 功能，从而改善患者生活质量。因大多数阴茎癌局限于阴茎头和包皮，故可通过器官保留手术进行治疗。本文旨 在描述每种术式的选择，包括阴茎癌不同术式的肿瘤学和功能结果。

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吴弘毅，胡辰，杨宏，等.阴茎癌的器官保留技术研究进展[J]. 泌尿外科杂志（电子版）,2023,15(4):62-67. DOI:10.20020/j.CNKI.1674-7410.2023.04.12

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1 背景

2 阴茎原发性肿瘤的治疗

    2.1 Tis 期

    2.2 Ta与 T1a期

    2.3 T1b与 T2期

    2.4 T3 期

    2.5 T4 期

3 宏观手术切缘

4 阴茎癌阴茎保留手术

    4.1 MMS

    4.2 包皮环切术和广泛局部切除术

    4.3 激光消融

    4.4 阴茎头表面修复术

    4.5 阴茎头切除术

    4.6 阴茎部分切除术

5 总结

原发性阴茎癌治疗目的是完全切除肿瘤，同时尽可能地保留器官功能。因大多数阴茎癌局限于阴茎头和包皮，故可以通过器官保留手术进行治疗。治疗应基于准确的术前分期、患者身体状况、外科医师等因素来实现个体化，如切缘阳性，应采用术中冰冻切片及再次手术，以达到切缘阴性。对于保留阴茎的患者，局部控制仍是有效的且局部复发对DSS 的影响较小。患者应密切监测自身病情，包括自我检查和医师进行体格检查。早期发现局部复发至关重要，在扩散至淋巴结和远处前应采取及时治疗。保留阴茎十分重要，让患者保留排尿功能和性功能，以提高术后患者生活质量和精神健康。

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