改良腹腔镜辅助下带血管蒂回肠代阴道成形术的探讨  

Study on modified laparoscope-assisted pedicled ileum graft for vaginoplasty

作　　者：张骏 黄金龙 张天琦 陈刚 ZHANG Jun;HUANG Jinlong;ZHANG Tianqi;CHEN Gang(Department of Plastic Surgery,A jfiliaied Hospital of Nanjing University of Chinese Medicine,Nanjing 210000,China)

机构地区：[1]南京中医药大学附属医院整形外科,江苏南京210000

出　　处：《中国美容整形外科杂志》2022年第3期169-172,I0008,共5页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨改良腹腔镜辅助下带血管蒂回肠代阴道改良成形术的有效性及安全性。方法自2012年1月至2018年1月,南京中医药大学附属医院整形外科收治16例因先天性无阴道或变性术后阴道狭窄患者,行腹腔镜辅助下带血管蒂回肠代阴道成形术。术中切取足够长度带蒂回肠转位入再造阴道腔穴,并于再造阴道口设计对偶三角皮瓣,防止阴道口出现环形瘢痕挛缩。再造阴道内放置模具3~6个月。结果所有患者术后获随访6个月至4年。所有患者再造阴道形态和功能接近正常,再造阴道深度平均12 cm,可容纳直径4 cm的柱状假体。术后无明显阴道狭窄、挛缩。结论改良腹腔镜辅助下带血管蒂回肠代阴道成形术创伤较小、效果较好,值得临床应用和推广。Objective To explore the effectiveness and safety of modified laparoscope-assisted pedicled ileum graft for vaginoplasty.Methods From January 2012 to 2018,16 patients with congenital absence of vagina or vaginal stenosis after male-to-female transsexual surgery underwent laparoscope-assisted pedicled ileum graft for vaginoplasty.During the operation,a pedicled ileum with sufficient length was cut and transferred into the reconstructed vaginal cavity.A dual triangular flap was designed at the reconstructed vaginal orifice to avoid circular scar contracture.The mold was placed in the reconstructed vagina for 3 to 6 months.Results All patients were followed-up for 6 months to 4 years.The morphology and function of reconstructed vagina was nearly normal in all patients.The depth of reconstructed vagina was 12 cm on average,and could accommodate the columnar prosthesis with a diameter of 4 cm.No obvious postoperative vaginal stenosis and contracture occurred.Conclusion The modified laparoscope-assisted pedicled ileum graft for vaginoplasty had less trauma and good efficacy.It should be considerable for clinical application and promotion.

关 键 词：腹腔镜 阴道成形术 带蒂回肠代阴道 对偶三角皮瓣 

分 类 号：R713.31[医药卫生—妇产科学]