Mukai Yuko, Sakurai Toru, Watanabe Toshiyuki, Sako Tomoko, Sugimoto Morito, Kimata Yoshihiro, Mori Yoshiko, Nagasaka Takeshi, Namba Yuzaburo
Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,
Acta Med Okayama. 2019 Jun;73(3):205-211. doi: 10.18926/AMO/56862.
Intestinal vaginoplasty has several advantageous features, such as scarless surgery, low incidence of contraction of the reconstructed vagina, maintenance of vaginal depth, spontaneous mucus production, and a low rate of complications. Therefore, this technique is becoming popular in many countries. Following the global trend, the demand for intestinal vaginoplasty for transsexuals is also increasing in Japan. However, there are few reports on intestinal vaginoplasty in Japan. In this study, we examined the safety and effectiveness of rectosigmoid colon vaginoplasty in the Japanese population. We retrospectively surveyed 18 male-to-female transsexuals who underwent laparoscopic rectosigmoid colon vaginoplasty at the Okayama University Hospital Gender Center between October 2012 and December 2017. One patient had developed an anastomotic leak and 2 patients experienced vaginal prolapse, which needed revision surgery. Both adverse outcomes were comparable with those from previous studies. The anastomotic leak was managed adequately with conservative treatment. To avoid vaginal prolapse, it is important to decide the length of the rectosigmoid segment so that a pull on it does not cause it to become lax, while excessive stress on the feeder vessels is avoided. Based on our study, we concluded that rectosigmoid vaginoplasty was a reliable technique in the Japanese population.
肠道阴道成形术有几个优点，如无痕手术、重建阴道收缩发生率低、阴道深度得以维持、能自发产生黏液以及并发症发生率低。因此，这项技术在许多国家越来越受欢迎。顺应全球趋势，日本对变性者进行肠道阴道成形术的需求也在增加。然而，日本关于肠道阴道成形术的报道很少。在本研究中，我们考察了乙状结肠阴道成形术在日本人群中的安全性和有效性。我们回顾性调查了2012年10月至2017年12月期间在冈山大学医院性别中心接受腹腔镜乙状结肠阴道成形术的18名男变女变性者。1例患者发生吻合口漏，2例患者出现阴道脱垂，均需进行修复手术。这两种不良结果与以往研究的结果相当。吻合口漏通过保守治疗得到了妥善处理。为避免阴道脱垂，确定乙状结肠段的长度很重要，这样牵拉时不会导致其松弛，同时要避免对供血血管施加过大压力。基于我们的研究，我们得出结论，乙状结肠阴道成形术在日本人群中是一种可靠的技术。
