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АЛТАЙСКИЙ ГОСУДАРСТВЕННЫЙ МЕДИЦИНСКИЙ УНИВЕРСИТЕТ
Бюллетень медицинской науки
Актуальность. Лоскутная пластика белочной оболочки полового члена (графтинг) при болезни Пейрони является методом выбора для оперативного лечения, особенно при тяжелых деформациях органа. Несмотря на большой перечень доступных материалов, нет единого представления об оптимальном лоскуте (графте).
Цель. Проанализировать все виды графтов, сравнить их эффективность и безопасность.
Материалы и методы. Поиск публикаций осуществлялся в Национальной медицинской библиотеке США и Центральной научной медицинской библиотеке Российской Федерации по ключевым словам: болезнь Пейрони, Пейрони, графт, лоскут, корпоропластика. Учитывались только оригинальные публикации и метаанализы. В итоге было отобрано 77 публикаций и проведена их описательная характеристика.
Результаты. Графтинг при болезни Пейрони является эффективным методом коррекции деформации полового члена. На сегодняшний день описано большое количество материалов для корпоропластики. Большинство исследований доказывают сопоставимую эффективность в отношении коррекции искривления полового члена. Несмотря на это, различия наблюдаются по частоте послеоперационных осложнений (эректильная дисфункция, рецидив деформации органа, фиброз лоскута). Предпочтение стоит отдавать ксено- и аутотрансплантатам, которые демонстрируют оптимальное сочетание биосовместимости, безопасности и удовлетворительных результатов. Напротив, синтетические материалы применять не рекомендовано. Аутовенозные графты, слизистая оболочка щеки, влагалищная оболочка яичка, бычий перикард, тонкокишечная подслизистая оболочка свиньи, а также коллагеновая гемостатическая губка ассоциированы с наибольшим процентом успеха, но и среди исследований в этих группах есть неудовлетворительные результаты.
Заключение. Несмотря на значительное количество опубликованных данных, ни один из существующих лоскутов не является «идеальным». Выбор графта должен осуществляться индивидуально, учитывая степень искривления полового члена, размеры бляшки и эректильную функцию пациента. Очевидным остается необходимость проведения дальнейших проспективных рандомизированных исследований в этом направлении.
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№ 2(2026) Бюллетень медицинской науки
