腹腔镜辅助带血管蒂回肠移植阴道成形术的临床应用

Laparoscopic assisted vaginal reconstruction using an ileal segment

目的探讨腹腔镜辅助带血管蒂回肠移植阴道成形术的手术方法及成功经验。方法回顾性分析2004年2月至2006年9月期间我院完成的腹腔镜辅助带血管蒂回肠移植阴道成形术53例患者的临床资料，对采用的手术方式及临床疗效进行观察和总结。结果53例手术均获得成功，外阴形态良好，人工阴道柔软、湿润，有皱襞，富有弹性，阴道宽2．5-4．0cm，深15—18cm；手术时间为（161±42）min，最短105min；术中出血30-51m1。结论带血管蒂回肠袢是较理想的人工阴道组织替代品，腹腔镜辅助下带血管蒂回肠移植阴道成形术是一种较理想的人工阴道成形方法。

Objectives The vaginal reconstruction is a complex problem and constitutes a significant technical challenge. Many techniques are used for vaginoplasty, including an isolated segment of small intestine, ascending colon, and sigmoid colon. We present our successful experience with laparoscopy assisted for vaginal reconstruction by the use of a modified ileal segment according to the Monti principle. Methods We analyzed the results of all 53 patients who underwented laparoeopie assisted ileal vaginoplasty in Beijing Anzhen Hospital between February 2004 and September 2006. Results All 53 operations were successful. The mean operation time was 161±42 min. Conclusion The results confirm the feasibility of laparescopic assisted perineal neovagina construction by ileal colpoplasty. Isolated ileal segments provids excellent tissue for vaginal replacement.