腹腔镜下腹膜阴道成形术致直肠损伤的临床处理(附16例分析)

Analysis of 16 cases of rectal injuries in the peritoneum vaginoplasties with the assistance of laparoscope

目的对该院腹腔镜腹膜阴道成形术中出现的直肠损伤病例进行分析,探讨腹膜阴道成形术术中出现直肠损伤的处理方法。方法对罗湖医院开展腹膜阴道成形术中出现的16例直肠损伤的情况进行回顾性分析。结果 16例直肠损伤患者中1例修补后改肠道阴道成形术,15例修补后仍行腹膜阴道成形术。15例中有10例一期愈合,5例出现直肠阴道瘘需二期修补,无1例行乙状结肠造瘘术。结论对于腹膜阴道成形术中出现的直肠损伤,只要做好肠道准备,术中使用合适的修补方法,一期修补仍可获得满意手术效果。

[Objective] To investigate the surgical treatment of rectal injuries which happened in the procedure of peritoneum vaginoplastic with the assistance of laparoscope, and find the way to manage it. [Methods] There were 16 cases of rectal injuries happened when the patients got the peritoneum vaginoplastic with the assistance of laparoscope, and clinical data of 16 cases with penetrating rectal injuries were retrospectively reviewed. [Results] operations were performed in all patients, 16 patients were treated with primary repair, and 10 cases were recovery well after they got the primary repair, 5 cases had rectum vagina fistulae, 2 cases had to change into laparoscopic sigmoid colon vaginoplasty. And no case was treated with colostomy. [Conclusion] Rectal primary repair is recommended as an effective procedure of rectal injuries in the peritoneum vaginoplastic with the assistance of laparoscope.