腹腔镜下带蒂回肠襻转移阴道再造术
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摘要
目的:探讨一种操作简便,更符合阴道生理特征的阴道再造术。方法:应用腹腔镜下带蒂回肠襻转移阴道再造术治疗7例有阴道再造需求的患者。结果:本组共7例,均采用腹腔镜下带蒂回肠襻转移阴道再造,术后恢复时间短,无肠道手术并发症发生,7例患者肠襻全部成活,术后瘢痕轻微,仅腹部腹腔镜切口可见瘢痕,再造阴道腔隙宽敞,质地柔软,分泌物量适中,无异味。结论:腹腔镜下带蒂回肠襻转移阴道再造术,术后再造阴道与正常阴道生理状态接近,会阴、大腿等处不产生新的可见手术瘢痕,易被患者接受,具有广泛的临床应用前景。
Objective To explore a kind of simple operation of vaginal reconstruction, and made it similar to vaginal physiological characteristic. Methods We reconstructed vaginal using pedicle ileum by laparoscopic for treatment of 7 patients with vaginal reconstruction needs. Results The operations were successfully completed in all the 7 cases. All pedicle ileum survived. The vaginal wall was soft, smooth and flexible. The vaginal secretion was mild and odorless. It meets the physiological needs and has satisfactory cosmetic effect. Conclusion After vaginal reconstruction with pedicled ileal by laparoscopic, the vagina is similar to normal vaginal physiology status. No visible surgical scar is in perineal and thigh, which is easy to be accepted by patients.And the method will have a broad clinical application prospect.
Objective To explore a kind of simple operation of vaginal reconstruction, and made it similar to vaginal physiological characteristic. Methods We reconstructed vaginal using pedicle ileum by laparoscopic for treatment of 7 patients with vaginal reconstruction needs. Results The operations were successfully completed in all the 7 cases. All pedicle ileum survived. The vaginal wall was soft, smooth and flexible. The vaginal secretion was mild and odorless. It meets the physiological needs and has satisfactory cosmetic effect. Conclusion After vaginal reconstruction with pedicled ileal by laparoscopic, the vagina is similar to normal vaginal physiology status. No visible surgical scar is in perineal and thigh, which is easy to be accepted by patients.And the method will have a broad clinical application prospect.
引文
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[2]黄志欣,刘培淑.阴道成形术的临床应用及研究进展[J].医学综述,2015,21(24):4509-4512.
[3]袁相斌,林子豪,何清濂,等.轴型皮瓣再造阴道126例经验体会[J].中华显微外科杂志,2001,24(3):170-171.
[4]Liu Y,Wang YF.Successful vaginal delivery at term after vaginal reconstruction with labium minus flaps in a patient with vaginal atresia:A rare case report[J]. J Obstet Gynaecol Res,2017,43(7):1217-1221.
[5]Le A,Wang Z,Shan L,et al. Analysis of rectal injuries resulting from laparoscopic peritoneal vaginoplasty(Luohu operation)[J].Clin Exp Obstet Gynecol,2016,43(2):250-253.
[6]Bianchi S,Berlanda N,Brunetti F,et al.creation of a neovagina by laparoscopic modified davydov vaginoplasty in patients with partial androgen insensitivity syndrome[J].Minim Invasive Gynecol,2017,24(7):1211-1217.
[7]van Houdt R,Ma B,Bruisten SM,et al.Lactobacillus iners-dominated vaginal microbiota is associated with increased susceptibility to Chlamydia trachomatisinfection in Dutch women:a case-control study[J].Sex Transm Infect,2018,94(2):117-123.
[8]胡珊,陈双郧,张春莲,等.腹腔镜下腹膜阴道成形术对阴道再造疗效的系统评价[J].中国美容整形外科杂志,2014,25(9):541-544.
[9]吴杰,郭瑞霞,褚丹霞,等.先天性无阴道患者腹腔镜下推腹膜阴道成形术和游离腹膜阴道成形术的临床效果比较[J].中华妇产科杂志,2018,53(2):121-123.
[10]麻荪香,程开祥,程辰,等.带血管蒂乙状结肠代阴道术[J].组织工程与重建外科杂志,2015,11(3):172-173.
[11]邬倩,王燕,郎雁,等.腹腔镜下腹膜代阴道成形术的临床观察[J].中国性科学,2017,26(10):57-59.
[12]李峰永,李森恺,周传德,等.自体口腔粘膜微粒联合脱细胞异体真皮基质再造阴道[J].中华整形外科杂志,2015,31(1):29-32.
[13]李峰永,李森恺,周传德,等.自体口腔粘膜微粒游离移植再造阴道术的远期随访[J].中华整形外科杂志,2017,33(Suppl):69-71.
[14]Ozkan O,Akar ME,Ozlenen O.Microvascular augmented pedicled jejunum transfer for vaginal reconstruction using a laparoscopyassiated technique[J].Microsurgery,2008,28(8):671-675.
[15]Ozkan O,Munie E,Ozlenen O.The use of vascularized jejunum flap for vaginal reconstruction:clinical experience and results in 22patients[J].Microsurgery,2010,30(2):125-131.
[2]黄志欣,刘培淑.阴道成形术的临床应用及研究进展[J].医学综述,2015,21(24):4509-4512.
[3]袁相斌,林子豪,何清濂,等.轴型皮瓣再造阴道126例经验体会[J].中华显微外科杂志,2001,24(3):170-171.
[4]Liu Y,Wang YF.Successful vaginal delivery at term after vaginal reconstruction with labium minus flaps in a patient with vaginal atresia:A rare case report[J]. J Obstet Gynaecol Res,2017,43(7):1217-1221.
[5]Le A,Wang Z,Shan L,et al. Analysis of rectal injuries resulting from laparoscopic peritoneal vaginoplasty(Luohu operation)[J].Clin Exp Obstet Gynecol,2016,43(2):250-253.
[6]Bianchi S,Berlanda N,Brunetti F,et al.creation of a neovagina by laparoscopic modified davydov vaginoplasty in patients with partial androgen insensitivity syndrome[J].Minim Invasive Gynecol,2017,24(7):1211-1217.
[7]van Houdt R,Ma B,Bruisten SM,et al.Lactobacillus iners-dominated vaginal microbiota is associated with increased susceptibility to Chlamydia trachomatisinfection in Dutch women:a case-control study[J].Sex Transm Infect,2018,94(2):117-123.
[8]胡珊,陈双郧,张春莲,等.腹腔镜下腹膜阴道成形术对阴道再造疗效的系统评价[J].中国美容整形外科杂志,2014,25(9):541-544.
[9]吴杰,郭瑞霞,褚丹霞,等.先天性无阴道患者腹腔镜下推腹膜阴道成形术和游离腹膜阴道成形术的临床效果比较[J].中华妇产科杂志,2018,53(2):121-123.
[10]麻荪香,程开祥,程辰,等.带血管蒂乙状结肠代阴道术[J].组织工程与重建外科杂志,2015,11(3):172-173.
[11]邬倩,王燕,郎雁,等.腹腔镜下腹膜代阴道成形术的临床观察[J].中国性科学,2017,26(10):57-59.
[12]李峰永,李森恺,周传德,等.自体口腔粘膜微粒联合脱细胞异体真皮基质再造阴道[J].中华整形外科杂志,2015,31(1):29-32.
[13]李峰永,李森恺,周传德,等.自体口腔粘膜微粒游离移植再造阴道术的远期随访[J].中华整形外科杂志,2017,33(Suppl):69-71.
[14]Ozkan O,Akar ME,Ozlenen O.Microvascular augmented pedicled jejunum transfer for vaginal reconstruction using a laparoscopyassiated technique[J].Microsurgery,2008,28(8):671-675.
[15]Ozkan O,Munie E,Ozlenen O.The use of vascularized jejunum flap for vaginal reconstruction:clinical experience and results in 22patients[J].Microsurgery,2010,30(2):125-131.