腹腔镜下乙状结肠代阴道成形术27例报告

目的探讨腹腔镜下乙状结肠代阴道成形术的手术方法及疗效。方法2006年6月～2007年6月施行27例腹腔镜下乙状结肠代阴道成形术。在腹腔镜下用超声刀切取带血管蒂的乙状结肠约15 cm,切取的移植肠襻从膀胱直肠凹处拉出作人工阴道,乙状结肠的远近端用管状吻合器行端端吻合。结果27例手术均获成功,术中出血量50～180 ml,平均82 ml。手术时间120～246 min,平均168 min。术后16 d发生不全肠梗阻1例,经保守治疗完全缓解。21例随访14～20个月,16例术后有性生活,均满意,余5例无性生活。结论腹腔镜下乙状结肠代阴道成形术创伤小,恢复快,具有一定的美学美容效果,是目前较理想的阴道成形方法。

Laparoscopy-assisted Sigmoid Colon Vaginoplasty: Report of 27 Cases

Objective To study the surgical techniques and effects of laparoscopy-assisted sigmoid colon vaginoplasty. Methods Clinical data of 27 patients, who underwent laparoscopy-assisted sigmoid colon vaginoplasty at Beijing Anzhen Hospital between June 2006 and June 2007, were retrospectively analyzed. A 15-cm segment of pedicled sigmoid colon was isolated using an ultrasound knife. The distal end of the segment was pulled into the vaginal space in the cul-de-sac of Douglas under a laparoscopic vision as the neovagina. The continuity of the intestinal tract （end-to-end bowel anastomosis） was restored using a circular mechanical suture through the rectum. Results The surgery was successfully completed in all the cases, no intra-operative complication occurred. The mean blood loss and operation time was 82 ml （50 -180 ml） and 168 min （120 -246 ml） respectively. One patient developed incomplete intestinal obstruction 16 days after the operation, and was cured by conservative treatment. Follow-up was available in 21 patients for 14 -20 months. Five patients had no sexual partner during the follow-up, while the other 16 patients were satisfied with their sexual lives after the surgeries. Conclusion Laparoseopie vaginal reconstruction using a sigmoid colon segment is satisfying for cosmetic, functional, and anatomic results.