全阴道切除及乙状结肠阴道成形术治疗早期阴道癌的术式探讨  

Evaluation of total vaginectomy and sigmoid neovagina in treatment of early stage vaginal cancer

作　　者：银铎[1] 王宁[1] 姜艳[1] 霍乃晨[1] 肖倩[1] 王晓明[1] 薛雪[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国现代医学杂志》2015年第9期94-98,共5页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:81202047);辽宁省自然科学基金计划(No:201202265);辽宁省医学高峰建设工程(No:2010696);沈阳市社会发展科技攻关专项(No:F11-262-9-15);中国医科大学附属盛京医院"盛京自由研究者"计划(No:200806)

摘　　要：目的回顾性评价全阴道切除术及乙状结肠阴道成形术在早期阴道癌患者中的治疗价值。方法严格选取2010年1月-2011年12月诊断为早期阴道癌并且有性生活需求的女性患者2例,采用全阴道切除术治疗,并同时采用乙状结肠法进行阴道重建,评价手术时间、术中出血、术中术后并发症及术后性生活满意程度。结果患者平均手术时间为(275.0±49.5)min,平均出血量为(297.5±24.7)ml,2例患者手术后均恢复良好,随访过程中无手术晚期并发症,无复发。采用乙状结肠法进行阴道重建后,2例患者均未出现阴道狭窄,术后性生活满意,女性性功能评分(FSFI)平均为(27.2±1.34)。结论尽管全阴道切除术对手术技术要求较高,目前应用相对较少,但全阴道切除术仍是早期阴道癌手术治疗方法中的重要手段。对于有性生活需求的患者,全阴道切除术及乙状结肠阴道成形术是治疗早期阴道癌的理想方法。【Objective】To retrospectively evaluate the value of total vaginectomy and reconstruction of vagina using sigmoid colon in the treatment of early stage vaginal cancer. 【Methods】Between January 2010 and December2011, two patients who were diagnosed as early stage vaginal cancer and had the needs of sexual life, were treated with total vaginectomy and sigmoid colon vaginoplasty. The operating time, blood loss, complications and satisfaction of sexual life were evaluated.【Results】The average operating time was（275.0 ± 49.5） min. The average estimated blood loss was（297.5 ± 24.7） ml. The two patients recovered well without any complication or recurrence. After sigmoid vaginal reconstruction, no stenosis was found and they both had satisfactory sexual life during the follow-up.The average Female Sexual Function Index（FSFI） was（27.2 ± 1.34）.【Conclusions】Though total vaginectomy is relatively less frequently used in early stage vaginal cancer for its requirement of high surgical skills, it is still an important surgical method. Vaginectomy with sigmoid colon vaginoplasty is a good choice of treatment for early stage vaginal cancer.

关 键 词：阴道癌 全阴道切除 乙状结肠阴道成形术 

分 类 号：R737.33[医药卫生—肿瘤]