直肠癌盆腔清扫术后带蒂回肠段修复阴道

REPAIR OF VAGINA WITH SEGMENT OF VASCULARIZED ILEAL GRAFT FOLLOWING PELVIC EXENTERATION FOR CARCINOMA OF RECTUM

目的探讨直肠癌行扩大的后盆腔清扫术，其全阴道切除或后侧壁切除后修复阴道的方法。方法１９９０年～１９９７年，对５例直肠癌行盆腔后清扫术，采用带蒂回肠段修复阴道，其中带蒂回肠段修复全阴道２例，带蒂回肠段，从对系膜缘剪开作阴道后侧壁修复３例。结果５例手术均获成功。随访６个月～６年，修复后的阴道宽度适当，壁较厚，弹性良好，周围瘢痕组织少。结论用带蒂回肠段作阴道修复，取材简便，回肠系膜血管弓有足够的长度可将回肠段移位至会阴部。回肠血供良好，易于愈合。

Objective To introduce a method to repair the vagina following pelvic exenteration for carcinoma of rectum in which the posterior wall of the vagina and cervix of the uterus were often involved.Methods From 1990 to 1997 segment of the vascularized ileum was used to repair the vagina in 5 cases, and in 2 of which the whole vagina was repaired while in the other 3 cases only the posterior wall of the vagina was repaired. Results All of the patients had successful results after operation repair.Conclusion Vascularized graft was an ideal material for the repair of vagina defect following pelvic exenteration for carcinoma of rectum, because this material was easily accessible, and its vascular pedicle was long enough for its transfering to the perineal region and the ileum had good blood supply which made healing easy. The vagina following repair had a thick posterior wall, good elasticity and very little scar tissue surrounded.