Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China.
Department of Gynecology, Hangzhou Women's Hospital, Hangzhou, Zhejiang, P. R. China.
J Obstet Gynaecol Res. 2022 Jul;48(7):1930-1937. doi: 10.1111/jog.15262. Epub 2022 Apr 23.
To introduce and compare the modified laparoscopic Vecchietti and Davydov techniques for vaginoplasty in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Moreover, the long-term treatment of vaginal agenesis was followed-up.
This comparative retrospective cohort study enrolled a total of 53 women with MRKH syndrome. The patients underwent surgical creation of a neovagina including 32 patients who underwent the modified laparoscopic Vecchietti technique, and 21 patients who underwent the modified laparoscopic Davydov technique from January 2009 to February 2019. The perioperative parameters, complications, anatomical, and functional outcomes of the two groups were compared. Patients' sexual functions were evaluated over a long-term follow-up using the female sexual function index (FSFI) and the revised female sexual distress scale (FSDS-R).
The medians (25th-75th) of the surgery duration for modified Vecchietti procedures was 50.0 (40.0-59.0) minutes, comparing to 135.0 (117.5-162.5) min for Davydov procedures (p < 0.001). The intraoperative blood loss was 20 (7.5-20.0) mL versus 50.0 (50.0-100.0) mL using the modified Vecchietti and Davydov approaches (p < 0.001), respectively. In the 39 follow-up cases, the lengths of the neovagina of the patients for Vecchietti group versus Davydov group were 7.9 ± 1.0 cm versus 8.6 ± 1.2 cm at 6 months after the vaginoplasty and 8.3 ± 0.7 cm versus 8.5 ± 0.9 cm after 2 years. There was no statistical difference in the FSFI and FSDS-R scores between the two groups.
Both the modified Davydov and Vecchietti laparoscopic procedures successfully achieved optimal anatomic and functional outcomes in treatments of vaginal agenesis. The modified Vecchietti technique is relatively simpler than the modified Davydov technique.
介绍并比较改良腹腔镜 Vecchietti 与 Davydov 技术在 Mayer-Rokitansky-Küster-Hauser（MRKH）综合征患者阴道成形术中的应用。此外，还对阴道发育不全的长期治疗进行了随访。
本回顾性队列研究纳入了 2009 年 1 月至 2019 年 2 月期间接受手术治疗的 53 例 MRKH 综合征患者。患者接受了包括 32 例接受改良腹腔镜 Vecchietti 技术和 21 例接受改良腹腔镜 Davydov 技术在内的阴道再造术。比较了两组患者的围手术期参数、并发症、解剖和功能结局。通过女性性功能指数（FSFI）和修订女性性功能困扰量表（FSDS-R）对患者的长期随访中的性功能进行评估。
改良 Vecchietti 手术的手术时间中位数（25-75 分位）为 50.0（40.0-59.0）分钟，而 Davydov 手术为 135.0（117.5-162.5）分钟（p<0.001）。改良 Vecchietti 组术中出血量为 20（7.5-20.0）mL，而 Davydov 组为 50.0（50.0-100.0）mL（p<0.001）。在 39 例随访病例中，Vecchietti 组与 Davydov 组患者阴道再造术后 6 个月时的阴道长度分别为 7.9±1.0cm与 8.6±1.2cm，术后 2 年时分别为 8.3±0.7cm与 8.5±0.9cm。两组的 FSFI 和 FSDS-R 评分无统计学差异。
改良腹腔镜 Davydov 与 Vecchietti 手术均可成功实现阴道发育不全的最佳解剖和功能结局。改良 Vecchietti 技术相对比改良 Davydov 技术更为简单。
