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双蒂动脉旋转乙状结肠阴道成形术治疗阴道发育不全

Double Pedicle Artery Rotation Sigmoid Vaginoplasty for Vaginal Aplasia Management.

作者信息

Handaya Adeodatus Yuda, Setyawan Nurcahya, Pangastuti Nuring, Barmawi Agus, Sofii Imam, Rahman Muhamad Nurhadi, Setyawati Ida Ayu, Hafiq Hamzah Muhammad

机构信息

Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

Department of Obstetrics and Gynecology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

出版信息

Ann Coloproctol. 2020 Jun;36(3):198-203. doi: 10.3393/ac.2018.10.30. Epub 2020 Jan 20.

DOI:10.3393/ac.2018.10.30
PMID:31991533
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7392576/
Abstract

Sigmoid vaginoplasty has been popular for neovagina reconstruction in vaginal aplasia. The most common surgical complication was vaginal stenosis caused by inadequate vascularization and tension because of graft length. Therefore, ischemia ensued and disrupted wound healing. The selection of double pedicle artery rotation sigmoid vaginoplasty is expected to reduce this problem. Five patients from April to December 2016 were diagnosed with vaginal aplasia; 4 had history of neovagina stenosis. These patients underwent sigmoid vaginoplasty with double pedicle artery rotation. No complications occurred during or after the procedure. Assessment postsurgery was conducted at 1 year. These results suggest that double pedicle artery rotation sigmoid vaginoplasty is a safe and acceptable technique for management of vaginal aplasia. The procedure decreased tension inside vascular pedicles as a result of maintaining abundant vascularization supply. Consequently, this procedure could avert graft necrosis, leakage, and severe stenosis. All of the patients exhibited regular menstrual cycle and satisfactory sexual activity. The outcomes were excellent with remarkable anatomical and functional results.

摘要

乙状结肠阴道成形术在先天性无阴道患者的新阴道重建中一直很受欢迎。最常见的手术并发症是由于血管化不足和移植物长度导致的张力引起的阴道狭窄。因此，出现了缺血并干扰了伤口愈合。双蒂动脉旋转乙状结肠阴道成形术的选择有望减少这个问题。2016年4月至12月，5例患者被诊断为先天性无阴道；4例有新阴道狭窄病史。这些患者接受了双蒂动脉旋转乙状结肠阴道成形术。手术期间及术后均未发生并发症。术后1年进行评估。这些结果表明，双蒂动脉旋转乙状结肠阴道成形术是一种安全且可接受的治疗先天性无阴道的技术。由于维持了丰富的血管供应，该手术降低了血管蒂内部的张力。因此，该手术可以避免移植物坏死、渗漏和严重狭窄。所有患者月经周期规律，性功能满意。结果非常好，在解剖和功能方面都有显著效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/8ca94041bd00/ac-2018-10-30f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/3f202fe5936c/ac-2018-10-30f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/0e41d3859e3f/ac-2018-10-30f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/7d240b2226f9/ac-2018-10-30f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/8ca94041bd00/ac-2018-10-30f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/3f202fe5936c/ac-2018-10-30f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/0e41d3859e3f/ac-2018-10-30f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/7d240b2226f9/ac-2018-10-30f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39a1/7392576/8ca94041bd00/ac-2018-10-30f4.jpg

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An Atypical Presentation of Vaginal Agenesis.
J Pediatr Adolesc Gynecol. 2015 Oct;28(5):e123-6. doi: 10.1016/j.jpag.2014.10.005. Epub 2014 Oct 24.
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The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies.ESHRE/ESGE 关于女性生殖道先天性畸形分类的共识。
Hum Reprod. 2013 Aug;28(8):2032-44. doi: 10.1093/humrep/det098. Epub 2013 Jun 14.
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Simultaneous development of ulcerative colitis in the colon and sigmoid neovagina.结肠溃疡性结肠炎与乙状结肠新阴道同时发生。
J Pediatr Surg. 2013 Mar;48(3):669-72. doi: 10.1016/j.jpedsurg.2012.12.025.
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Vaginal agenesis, the hymen, and associated anomalies.阴道发育不全、处女膜及相关异常。
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Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging.三维超声在 Müllerian 管畸形诊断中的应用及与磁共振成像的一致性。
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