中国实用妇科与产科杂志

中国实用妇科与产科杂志

• 专题笔谈 • 上一篇    下一篇

腹腔镜肠道阴道成形术的手术要点

  

  1. 1.上海交通大学医学院附属第九人民医院妇产科，上海200011；2.上海中医药大学附属曙光医院妇产科，上海 200251
  • 出版日期:2018-04-02 发布日期:2018-04-02
  • 通讯作者: 刘建华

Surgical key points of laparoscopic vaginoplasty with intestine

  1. Department of Obstetrics and Gynecology，Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine，Shanghai 200011，China
  • Online:2018-04-02 Published:2018-04-02

摘要：

用肠道（乙状结肠或回肠）进行阴道重建可以在腹腔镜下完成，但与剖腹手术相比较应注意如下几个方面：（1）所取肠段的选定，既要切取足够的长度，又要保证肠段的血液供应不受损伤。（2）肠段切取时，尤其是乙状结肠切取时要注意肠腔内容物对腹腔的污染，避免术后腹腔感染和肠吻合口的愈合不良。（3）应用肠吻合器时，可在下腹部做辅助小切口，或经阴道的造穴完成肠吻合。（4）术前的肠道准备及术后管理要同样重视。

关键词: 腹腔镜手术, MRKH综合征, 阴道成形术, 肠管

Abstract:

The intestine vaginoplasty（with sigmoid or ileum）can be finished under laparoscope.Compared with laparotomic procedure，laparoscopic intestine vaginoplasty should focus on the following aspects：（1）how to select the proper segment of sigmoid colon to meet the length and blood supply of neovagina；（2）in the preparation of sigmoid segment for neovagina，it's necessary to prevent the content of colon from polluting the peritoneal cavity and to avoid postoperative peritoneal infection；（3）a mini-incision should be made in lower abdominal wall for intestinal stapler to be used successfully，or intestinal stapler should be used by way of the artificial vaginal cave；（4）the preoperative intestinal preparation and the postoperative management are just as important to the success of vagionplasty.

Key words: laparoscopic surgery, MRKH syndrome, vaginoplasty, intestine

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