腹腔镜下带血管蒂回肠移植阴道成形术25例临床分析-《中国微创外科杂志》

文章信息/Info

Title:: Laparoscopic vaginoplasty using a vascularized pedicled ileal flap: Analysis of 25 cases

Author(s):: Wu Jixiang; Li Bin; LiWenzhi; et al.; *Department of General Surgery, Beijing AnzhenHospital of Capital University of Medical Sciences, Beijing 100029, China

Keywords:: Laparoscopy; 　Congenital absence of the vagina; 　Ileum; 　Vaginoplast

摘要:: 目的探讨腹腔镜下带血管蒂回肠移植阴道成形术的疗效. 方法回顾性分析2004年3～11月我院25例腹腔镜下带血管蒂回肠移植阴道成形术的临床资料,其中全腹腔镜手术7例,腹腔镜辅助下手术18例. 结果 25例手术均成功,术后近期发生肠梗阻1例,经2次手术治愈;阴道口狭窄2例,1例经扩张、1例经阴道口成形术后痊愈.17例随访3～6个月,11例无异味,6例轻度异味;9例有性生活,7例满意,1例有少量出血,1例阴道短. 结论腹腔镜下带血管蒂回肠移植阴道成形术创伤小,较符合生理状态,安全可靠,疗效良好,是目前较理想的阴道成形方法.

Abstract:: Objective　To investigate curative effects of laparoscopic vaginoplasty using a vascularized pedicled ileal flap.　 M ethods　A retrospective analysis was made on 25 cases of laparoscopic vaginoplasty by using a vascularized pedicled ileal flap, including 7 cases of total laparoscopic surgery and 18 cases of laparoscopically assisted surgery.　Results　Operations were successfully completed in all the 25 cases. Short- term complications in the immediate postoperative period included 1 case of intestinal obstruction, which was cured by a secondary surgery, and 2 cases of stricture of vaginal orifice, which were cured by a vaginal dilatation and an orifice reconstruction respectively. Follow-up for 3~6 months in 17 cases found no abnormal smelling vaginal discharge in 11 cases and mild abnormal smelling in 6 cases. Among 9 patientswho had a sexual life, 7 were satisfied with their sexual activities, 1 had small amounts of hemorrhage, and 1 reported a short vaginal length.　Conclusions　Laparoscopic vaginoplasty using a vascularized pedicled ileal flap is safe, reliable and effective. Itmay meetmost expectations, being an ideal approach ofminimally invasive vaginoplasty.