同种异体脱细胞真皮基质在膀胱阴道瘘修补术中的应用

Usage of acellular dermal matrix allograft as a novel technikue in the treatment of vesicovaginal fistula

目的评价同种异体脱细胞真皮基质(ADMA)在膀胱阴道瘘修补术中的应用价值。方法对8例复杂性膀胱阴道瘘患者进行了手术治疗,术中均采用了ADMA作为组织替代物。采用腹膜外经膀胱途径进行膀胱阴道瘘修补,术中将ADMA置入阴道、膀胱之间。结果所有病例均未发生任何手术并发症。术后阴道漏尿停止,保留尿管4周,随访6-12月,未见复发。结论在膀胱阴道瘘手术治疗中,采用ADMA替代自体组织,手术效果确切,时间短,尤其避免了以往获取自体组织所带来的创伤。

Objective To describe an effective and simple method for repairing vesicovaginal fistula （VVF） using an aceUular dermal matrix allograft （ADMA）. Methods We reviewed retrospectively 8 women suffering from VVF after surgical trauma or prolonged obstructed labour who underwent transabdominal ,extraperitoneal repair of their complicated VVF using an ADMA technique between December 2005 and August 2006. The preoperative and postoperative mdeical records were reviewed. Results All patients noted an immediate result with no evidence of leakage, and remain dry at follow-up,for 6-12 months. No intraoperative or postoperative complications occurred, Conclusion The free ADMA technique is a simple,effective,and mini-invasive method for complex VVF repair,obviating the need for rotational flaps.