摘要
目的：探讨腹腔镜腹膜阴道成形术人工穴道的形成方法及并发症的预防措施。方法：2007年11月至2013年11月为391例先天性无阴道患者施行腹腔镜腹膜阴道成形术（罗湖Ⅱ式），观察分析其手术情况、手术效果及并发症情况。结果：390例顺利完成腹腔镜手术，1例中转开腹行带血管蒂回肠代阴道成形术。手术时间平均（55±15）min；术中中位出血量10ml。其中直肠损伤8例，发生率2．05％，无膀胱尿道损伤。术后21-28d阴道长度8～12cm，平均（9．0±1．5）cm。结论：人工造穴是腹腔镜腹膜阴道成形术的关键步骤之一，术中应预防出血及膀胱直肠损伤等并发症的发生。弹头型阴道扩张棒使人工造穴手术操作更简单、安全，术中使用水压分离可有效减少膀胱及直肠损伤。
Objective： To investigate the procedure of laparoscopic peritoneal vaginoplasty （ Luohu- Ⅱ ） in congenital absence of vagina,and discuss the creation of neovaginal tunnel and the prevention of complications. Methods：The clinical data of 391 patients who suffered from congenital absence of vagina and underwent laparoscopic peritoneal vaginoplasty （ Luohu- Ⅱ ） from Nov. 2007 to Nov. 2013 were retrospectively analyzed. Their operative situations,effects and complications were analyzed. Results： Laparoscopic peritoneal vaginoplasty was successfully completed in 390 cases. Only 1 case was converted to laparotomy, vaginoplasty using a vascularized pediclod ileal flap was preformed. The operation time ranged from 40 to 120 min with an average of （55 ± 15） min. The median blood loss was 10 ml. There were 8 cases of rectum injury occurred with the incidence of 2.05%. No bladder and urethra injury were found. The average vaginal length at 21 d to 28 d after operation ranged from 8 to 12 cm with an average of （9.0 ± 1.5） cm. Conclusions：Successful creation of artificial vagina tunnel is the key step in laparoscopic peritoneal vaginoplasty. It is important to reduce bleeding and avoid bladder and rectum injury during the procedure. The application of vaginal dilator expanding the artificial vagina can simplify vaginoplasty and it is easy and safe to perform, and the application of water pressure separating can effectively avoid bladder and rectum injury.
出处
《腹腔镜外科杂志》
2014年第6期411-414,共4页
Journal of Laparoscopic Surgery
关键词
先天性无阴道
腹膜阴道成形术
腹腔镜检查
人工造穴
Congenital absence of vagina
Peritoneal vaginoplasty
Laparoscopy
Creation of neovaginal tunnel
