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腹腔镜下子宫-阴道吻合术治疗先天性宫颈-阴道闭锁患者:23 例机构经验。

Laparoscopic uterovaginal anastomosis in patients with congenital cervicovaginal atresia: An institutional experience with 23 patients.

机构信息

Department of Gynecology, Southern University of Science and Technology Hospital, Shenzhen, Guangdong, 518000, PR China.

Department of Obstetrics and Gynecology, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, 518000, PR China.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 May;260:218-224. doi: 10.1016/j.ejogrb.2021.03.034. Epub 2021 Mar 31.

DOI:10.1016/j.ejogrb.2021.03.034
PMID:33848707
Abstract

OBJECTIVE

To introduce our experience of laparoscopic uterovaginal anastomosis and operative outcomes following this technique and update the clinical management of congenital cervicovaginal atresia.

STUDY DESIGN

Between March 2015 and January 2019, twenty-three patients with congenital cervicovaginal atresia underwent laparoscopic uterovaginal anastomosis and Luohu procedure. Their clinical characteristics, surgical outcomes and follow-up data were retrospectively reviewed.

RESULTS

The mean ± SD age of the cases was 16.4 ± 4.0 (11-26) years. All patients had a history of primary amenorrhea and cyclical abdominal pain, and the average delay in diagnosis from first symptoms was 33.5 ± 38 (1-156) months. Most of the patients had 1-3 cm long vaginal pouch. The operative procedure lasted 125 ± 32 (80-190) min. The average vaginal length at 1 month was 7.9 ± 1.3 (range 6-9) cm. All patients showed resumption of menstruation. The patients were followed for a mean of 27 ± 13 (12-56) months. During the follow-up, cervical stenosis did not occur in any of the cases.

CONCLUSION

Laparoscopic uterovaginal anastomosis with Luohu procedure provided a minimally invasive, safe, and effective surgical option for the patients with congenital cervicovaginal atresia. The technique is uncomplicated, easy to learn and perform, and provides a functional and anatomic satisfactory result. No special surgical instruments are required with this technique.

摘要

目的

介绍我们在腹腔镜下进行子宫阴道吻合术的经验和手术结果,并更新先天性宫颈阴道闭锁的临床处理方法。

研究设计

2015 年 3 月至 2019 年 1 月,23 例先天性宫颈阴道闭锁患者接受了腹腔镜下子宫阴道吻合术和 Luohu 手术。回顾性分析了他们的临床特征、手术结果和随访资料。

结果

患者的平均年龄为 16.4 ± 4.0(11-26)岁。所有患者均有原发性闭经和周期性腹痛病史,平均从首发症状到确诊的延迟时间为 33.5 ± 38(1-156)个月。大多数患者的阴道囊长度为 1-3 cm。手术时间为 125 ± 32(80-190)分钟。术后 1 个月阴道长度平均为 7.9 ± 1.3(6-9)cm。所有患者均恢复了月经。患者平均随访 27 ± 13(12-56)个月。随访期间,所有患者均未发生宫颈狭窄。

结论

腹腔镜下子宫阴道吻合术联合 Luohu 手术为先天性宫颈阴道闭锁患者提供了一种微创、安全、有效的手术选择。该技术操作简单,易于学习和实施,可获得满意的功能和解剖学效果。该技术不需要特殊的手术器械。

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