腹腔镜辅助下截取带血管蒂回肠段转移阴道成形术.pdfVIP

中华猿形外科杂志 2∞6 年 9 月第 22 糊糊 Chín J Plast S吨， Spe. 2刷 Vo1. 22 No.5 ? 339 . ·会阴部黯形· 腹腔镜辅助下截取带血管带回肠段转移 阴道成形术 赵耀忠江 i革振江华仇明林子豪朱晓海郑向民袁相战章建林吴宏 陈敏亮 刘安堂 {摘襄] 目的 探索在腹腔镜辅助 F 截取带血管蒂固肠段转移再造阴道的可能性，为临床提 供阴道成形术的新方法。方法 应用腹腔镜引导下，配合使用超声刀，通过小切口完成肠系膜分 离、回肠段截椒、肠端吻合、四肠段下拉转移形成阴道。结果 2∞2 年 2 月蓝 2∞6 年 7 月，共为 38 例筒再造阴道患者成功地施行腹腔镜辅助下棋取带血管蒂阔肠段转移阴道成形术。随访 1 个月 -4 年，其中 36 例移樵回肠段成活良好，再造阴道符合生理要求。结论 由于避免了剖腹和以往术式的 供服搬痕，较好地握解了此类患者旦大的心理压力，腹腔镜下回肠段代阴道是目前较为理想的阴道 成形术新方法。 {关键诩}阴道成形术 腹腔镜 切l 肠段转移 Laparωcopic small ?ntesünal flap colpopoiesis ZHAO Yao- Zhong 势 ， JIANG Dt阶 Zhen ， JIANG Hi阳 ， QIU Ming , llN Zi-H俐， ， ZHU Xiα萨 Hai ， ZHENG Xiang-Min , YUAN Xiαn伊 Bin ， ZHANG Jian-Lin , WU Hong , CHEN Min- Lia咽 ， llU An刷 tang. 传 Depα rtment 0/ Plastic SU1咨eI-y， Chαngzheng Ho战pital ， Second Milí阳市 Medical University , Shαnghα i 2ω003 ， China [Abstract] Objective To ü附 stìgate the 阴阳ihility of Laparoscopic reconst 附 tion of vagina using pedicled ileal autograft and provide a new procedure of colpopoiesis. Methods The abdominal and perineal approaches were performed simultaneously under a sufficiently deep general anaesthesia. Laparoscopiclly , a 15 - 18cm segment of the ileum on its vascular pedicle , ileal branches of the superior mesenteric arterγand its concolllitant veins , was selected and isolated for transplantation using ultrasonically-powered instrulllents. 叽m distal of the transferred ileal 时 glllent was 15clll apart from the ileocecal junction. The ileum continuity was restored immediately by end-to-end anastomosis and the distal oral of the transplant was closed using a curved intraluminal stapler. Meanwhile , a neovaginal tract was cO