球体替代纽扣改良腹腔镜Vecchietti阴道成形手术12例临床分析

The clinical research of 12 patients operated by the improved laparoscopic Vecchietti vaginoplasty alternatived by bead

目的:探讨用球体替代纽扣实施腹腔镜Vecchietti阴道成形手术的可行性和临床效果的优越性。方法:选取2003年至2012年在山东大学齐鲁医院妇科行腹腔镜Vecchietti阴道成形术的20例先天性无阴道患者,其中行传统腹腔镜Vecchietti阴道成形手术者8例(纽扣组),用球体替代纽扣实施改良腹腔镜Vecchietti阴道成形手术者12例(球体组)。比较两组的手术时间、术中出血量、术后提拉疼痛评分,以及术后3月及6月的阴道长度(cm)和宽度(cm)。结果:球体组的手术时间、术中出血量、术后疼痛评分(VAS)均显著低于纽扣组(P<0.05)。术后3月及6月复查,两组患者的阴道长度及宽度均无显著差异(P>0.05)。结论:应用球体替代纽扣改良腹腔镜Vecchietti阴道成形手术与传统腹腔镜Vecchietti阴道成形手术相比较,缩短了手术时间,减少术中出血量,明显缓解患者术后提拉疼痛,同时又保留传统手术方式的优点,是一种创伤更小、更加简约可行的手术方式。

Objective：To discuss the improved laparoscopic V ecchiett： vagmopLasty al-ternative by bead and to study its clinical effect. Methods：Twenty patients with vaginal agene-sis （Mayer-Rokitansky-Kuster-Hauser syndrome） were reviewed,including twelve patients car-fled out by improved laparoscopie Veechietti vaginoplasty ahernatived by bead （the improved group） and eight by traditional laparoscopic Vecchietti vaginoplasty （the traditional group）. The operation time, the amount of bleeding, the length and width of neovagina after three months and six months of the operation and the VAS score of operation were compared between the two kinds of operations. Results：The mean operating time and the average amount of bleeding and the VAS score of the two teams were distinguishing,the improved group was better （P〈0.05）. Whatever, the length and width of neovagina after three months and six months of the operation were not different （P〉0.05）. Conclusions： Compared the operation of improved laparoscopic Vecchietti vaginoplasty ahernatived by bead with the traditional laparoscopic Vecchietti vagino-plasty, the former not only have the advantage of the traditional laparoscopic Vecchietti vagino-plasty, that is the neovagina is close to natural vagina both functionally and anatomically, but al-so have its own advantage that is the shorter operating time, the less amount of bleeding and it can relief the ache after the operation obviously. In conclusion, the improved laparoscopic Vec-chietti vaginoplasty ahernatived by bead promises to be a widely used and minimally invasive operation of vaginoplasty.