摘要
目的:比较在腹腔镜下行带血管蒂回肠移植再造阴道两种术式的效果,为临床提供阴道成形手术新方法。方法:(1)全腹腔镜下回肠代阴道成形术(1例):应用腹腔镜引导,配合使用超声刀、线形切割器,不开腹完成肠系膜分离、回肠段切取、肠端吻合、回肠段下拉移植成形阴道;(2)腹腔镜辅助下回肠代阴道成形术(12例):腹腔镜下选择移植肠段,经扩大右麦氏点切口将移植肠段取出腹外完成肠系膜分离、回肠段切取、肠端吻合后,将移植肠段及吻合后的回肠送入腹腔,腹腔镜辅助下完成回肠段下拉移植成形阴道。结果:2002年2月以来,为13例需再造阴道患者成功地施行了腹腔镜下带血管蒂回肠移植阴道成形术,随访1个月至3年,移植回肠段成活良好,再造阴道符合生理要求。方法(1)美容效果更佳,但操作难度大,费用较高。结论:由于避免了剖腹和以往术式的供区瘢痕,极大地缓解了此类患者巨大的心理压力,腹腔镜下回肠代阴道是目前较为理想的阴道成形方法,可根据患者需求选择相应术式。
Objective:To study the effects of 2 methods for laparoscopic vaginoplasty using ileal segment. Methods: Method 1 was total laparoscopic vaginoplasty(1 patient). The ileum segment on its vascular pedicle was isolated and reversed under full laparoscopy to reach the perineum through neovaginal tract without open operation. Method 2 was assistant laparoscopic vaginoplasty(12 patients). The ileum segment on its vascular pedicle was selected by laparoscopy and was directly dissected outside abdomen through the enlarged Mcway point incision, then the ileum continuity was restored immediately by end-to-end anastomosis. Finally the ileum transplant was reversed to the perineum through the neovaginal tract by laparoscopy. An opening made to the ileum transplant was sutured to the perineal skin. Results: During a follow-up of 1-36 months, all the 13 patients got satisfactory neovaginal function similar to that of normal vagina with mucus and moistness. Method 1 was more esthetically acceptable, while its cost is more and the operation is more difficult.Conclusion: Because of minimal scarring in abdomen and less secondary mental stress, laparoscopic vaginoplasty is a preferable alternative for vaginoplasty. The choice of methods is left to the patients.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2005年第1期10-12,共3页
Academic Journal of Second Military Medical University
基金
上海市卫生系统百名跨世纪优秀学科带头人培养基金(1999076).
关键词
阴道成形
腹腔镜
回肠
vaginoplasty
laparoscopic
ileum
