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[迈耶-罗基坦斯基-库斯特-豪泽综合征中韦基耶蒂法与达维多夫法腹腔镜阴道成形术的比较研究]

[Comparison study between Vecchietti's and Davydov's laparoscopic vaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome].

作者信息

Dong Xiaochao, Xie Zhenwei, Jin Hangmei

机构信息

Department of Obstetrics and Gynecology, Hangzhou First People's Hospital, Hangzhou 310006, China.

Email:

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2015 Apr;50(4):278-82.

Abstract

OBJECTIVE

To compare Vecchietti's and Davydov's laparoscopic techniques for vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.

METHODS

From January 2010 to December 2013, 13 patients underwent the Vecchietti's laparoscopic procedure (Vecchietti group), and 15 patients underwent the Davydov's laparoscopic procedure (Davydov group). Intraoperative parameters and postoperative results were compared.

RESULTS

Both of the two groups were successfully treated. The neovagina in both groups were wide with good elasticity, softness and smoothness. The operation time [(39±7) versus (73±11) minutes], the intraoperative blood loss [(21±6) versus (63±10) ml], the anal exsufflation time after surgery [(19±5) versus (28±6) hours] and the recovery period of body temperature after surgery [(35±10) versus (46±10) hours] of the Vecchietti group were less than those of the Davydov group (all P<0.05). But the neovagina length [(8.8±0.5) versus (9.6±0.5) cm] was shorter and the Female Sexual Function Index scale score [26.8±2.0 versus 28.5±1.7] was lower in the Vecchietti group than those in the Davydov group (all P<0.05). The postoperation hospital duration didn't reached statistical difference between the two groups [(7.5±0.9) versus (7.1±0.7) days, P>0.05]. No intraoperative complication occurred. After surgery, 2 patients were found vaginal polyps and 8 patients were suffered from pain in the Davydov group, while all patients were suffered from pain in the Vecchietti group.

CONCLUSIONS

Both Vecchietti's and Davydov's laparoscopic techniques are simple, safe and effective surgical methods for vaginal reconstruction. In contrast, the Vecchietti's procedure is more time efficient and minimally invasive, while the Davydov's procedure can get less pain, longer vagina and higher sexual satisfaction.

摘要

目的

比较韦基耶蒂(Vecchietti)和达维多夫(Davydov)腹腔镜技术用于迈耶-罗基坦斯基-库斯特-豪泽(MRKH)综合征患者阴道成形术的效果。

方法

2010年1月至2013年12月,13例患者接受了韦基耶蒂腹腔镜手术(韦基耶蒂组),15例患者接受了达维多夫腹腔镜手术(达维多夫组)。比较两组的术中参数和术后结果。

结果

两组均成功治疗。两组的新阴道均宽大,弹性、柔软度和光滑度良好。韦基耶蒂组的手术时间[(39±7)对(73±11)分钟]、术中出血量[(21±6)对(63±10)毫升]、术后肛门排气时间[(19±5)对(28±6)小时]和术后体温恢复时间[(35±10)对(46±10)小时]均少于达维多夫组(均P<0.05)。但韦基耶蒂组的新阴道长度[(8.8±0.5)对(9.6±0.5)厘米]较短,女性性功能指数评分[26.8±2.0对28.5±1.7]低于达维多夫组(均P<0.05)。两组术后住院时间无统计学差异[(7.5±0.9)对(7.1±0.7)天,P>0.05]。术中无并发症发生。术后,达维多夫组发现2例阴道息肉,8例疼痛,而韦基耶蒂组所有患者均有疼痛。

结论

韦基耶蒂和达维多夫腹腔镜技术都是用于阴道重建的简单、安全且有效的手术方法。相比之下,韦基耶蒂手术更省时且微创,而达维多夫手术疼痛更少、阴道更长且性满意度更高。

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