Zhao Muxin, Li Qiang, Li Pengcheng, Zhou Chuande, Duan Chenwang, Huang Xunlei, Chen Bin, Liu Xiaoji, Li Senkai
Second Department of Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Mar;23(3):309-12.
OBJECTIVE To investigate the effect of vaginal reconstruction with autologous buccal micro-mucosa graft.
From March 2007 and April 2008, 10 patients with absence of vagina were treated, aged 18-31 years (mean 26 years). Nine of them were congenital absence of vagina, and the remaining one was vaginal stenosis after vaginal reconstruction. They all exhibited normal secondary sexual characteristics, normal hormonal levels and 46, XX karyotype. Their abdominal ultrasonography revealed the normal ovaries and tubes but absence of the uterus or small rudimentary horns. However the one with vaginal stenosis had normal uterus. The buccal mucosa graft was minced into 0.5 mm in size and was transplanted to the cavity which was dissected between the bladder and the rectum.
The operation was performed successfully in all cases. The operative time was about 1-2 hours and operative blood loss was 80-100 mL. Postoperative complication occurred in only one case for vaginal bleeding. The patient recovered and the wound healed well after immediate management. The others healed primarily without any complications. All cases were followed up for 4-16 months. The depth of neovagina which was formed was 6-10 cm and the width was about two fingers. The lining was pink-colored and smooth, and was confirmed as nonkeratinizing squamous stratified mucosa by histopathological examination. The donor sites healed uneventfully with no change in mouth opening. The perineal area was not disturbed. Four patients were married and satisfied with their sexual life without pain and bleeding.
Vaginal reconstruction with autologous buccal micro-mucosa graft is an easy, minimally invasive and useful method.
目的 探讨自体颊黏膜移植阴道再造术的效果。
2007年3月至2008年4月，对10例阴道缺失患者进行治疗，年龄18 - 31岁（平均26岁）。其中9例为先天性阴道缺失，其余1例为阴道再造术后阴道狭窄。她们均表现出正常的第二性征、正常的激素水平及46，XX核型。腹部超声检查显示卵巢和输卵管正常，但子宫缺如或仅有小的残角。然而，阴道狭窄的患者子宫正常。将颊黏膜移植片切成0.5毫米大小，移植到膀胱与直肠之间分离出的腔隙中。
所有病例手术均成功。手术时间约1 - 2小时，术中出血量80 - 100毫升。术后仅1例出现阴道出血并发症。经及时处理后患者康复，伤口愈合良好。其他患者一期愈合，无任何并发症。所有病例随访4 - 16个月。形成的新阴道深度为6 - 10厘米，宽度约为两指宽。内衬呈粉红色，光滑，组织病理学检查证实为非角化复层鳞状黏膜。供区愈合良好，开口无变化。会阴区未受影响。4例患者结婚，对性生活满意，无疼痛及出血。
自体颊黏膜移植阴道再造术是一种简便、微创且有效的方法。
