腹腔镜下带血管蒂回肠移植阴道成形术72例回顾  

Laparoscopic Vaginal Reconstruction Using An Ileal Segment:A Retrospective Report of 72 Cases

作　　者：魏常胜[1] 伍冀湘[1] 梁杰雄[1] 

机构地区：[1]首都医科大学附属北京安贞医院普通外科

出　　处：《首都医科大学学报》2008年第4期518-520,共3页Journal of Capital Medical University

摘　　要：目的总结腹腔镜下带血管蒂回肠移植阴道成形术的经验,比较全腹腔镜手术和腹腔镜辅助手术在临床中的应用。方法回顾性分析2004年2月至2006年9月期间首都医科大学附属北京安贞医院完成的腹腔镜下带血管蒂回肠移植阴道成形术临床病理资料共72例。结果72例手术均获得成功,外阴形态良好,人工阴道柔软湿润,有皱襞,富有弹性,阴道宽2.5～4.0cm,深15～18cm;全腹腔镜组手术时间最短为120min,腹腔镜辅助手术组手术时间最短为105min,2组手术时间比较差异无统计学意义。结论带血管蒂回肠袢是较好的人工阴道组织替代品,腹腔镜或腹腔镜辅助下带血管蒂回肠移植阴道成形术是一种较理想的人工阴道成形方法。Objective The surgical management of the congenital absence of vagina（ Mayer-Rokitansky-Kuster-Hauser syndrome） and male-to-female transsexuals are a complex problem which refered to a significant technical challenge. The methods used for vaginoplasty induce including the split-thickness skin graft, full-thickness skin graft, and inverted penile skin flap. However, these procedures are not entirely satisfactory in cases of reconstructed vaginal stenosis, inadequate vaginal length, or poor lubrication. The small intestine, ascending colon, and sigmoid colon can be used in the intestinal flap method. Herein we present our successful experience with laparoscopy for vaginal reconstruction by the use of a modified ileal segment according to the Monti principle. At the same time, we compared with the difference between laparoscopic vaginal reconstruction and laparoscopic assisted vaginal reconstruction. Methods We analyzed the results of all 72 patients who underwent laparoeopic ileal vaginoplasty in Beijing Anzhen Hospital between February of 2004 and September of 2006. Results All the operations were successful. The mean operating time had not significance difference between total laparoscopic vaginoplasty and laparoscopic assisted ileal vaginoplasty （ P 〉 0. 05 ）. Conclusion Our results have confirmed the feasibility of laparoscopic perineal neovagina construction by ileal colpoplasty, total laparoeopic or laparoscopic assisted. Isolated ileal segments provided excellent tissue for vaginal replacement.

关 键 词：腹腔镜 回肠 阴道成形术 

分 类 号：R713.3[医药卫生—妇产科学]