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[一种治疗有功能子宫的阴道闭锁的新方法]

[A new method in the treatment of vaginal agenesis with functioning uterus].

作者信息

Sato H

出版信息

Hokkaido Igaku Zasshi. 1987 May;62(3):476-84.

PMID:3610039
Abstract

A new surgical method to construct the vagina was invented, using the mucosa of the vestibule of vagina in 4 patients with absence of the entire vagina with non-canalization of the cervix and 4 patients with absence of the lower vagina with a well-developed cervical canal. This new method to construct the vagina has the following advantages superior to the usual methods in which tissues and/or organs from other parts of the body, such as skin (McIndoe) and intestine are used, 1) preservation of fertile uterus, 2) construction of physiological vagina hormonally controlled by ovaries, 3) no occurrence of vaginal reshortening and restenosis, 4) less scar formation on the surface of the body. In both groups of patients, vagina was firstly constructed non-surgically with a depth of 3-6 cm, using vaginal dilators. In the former patients, connective tissues between bladder and rectum was separated, the external os of the uterus, which was observed either by laparotomy or by laporoscopy, was made with Kelly forceps, and the uterine cervix was sutured with the mucosa of the constructed vagina. In the latter group, the operation was much easier than that of the former. The incision was made both at the bottom of the non-surgically constructed vagina and at the surface of the hematoma being under the uterine cervix. The mucosa of the vagina was sutured with incised edge of the hematoma. In all of the subjects, menstrual bleeding occurred through the cervix 1-3 months after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

发明了一种新的阴道构建手术方法,该方法应用于4例完全性阴道缺失且宫颈无管腔形成的患者以及4例阴道下段缺失但宫颈管发育良好的患者,采用阴道前庭黏膜。这种构建阴道的新方法具有以下优于常用方法(使用身体其他部位的组织和/或器官,如皮肤(麦金杜法)和肠道)的优点:1)保留有生育功能的子宫;2)构建受卵巢激素控制的生理性阴道;3)不会出现阴道缩短和再狭窄;4)体表瘢痕形成较少。两组患者均首先使用阴道扩张器非手术构建深度为3 - 6厘米的阴道。对于前者,分离膀胱和直肠之间的结缔组织,通过剖腹手术或腹腔镜观察子宫外口,用凯利钳制作子宫外口,将子宫颈与构建阴道的黏膜缝合。对于后者,手术比前者容易得多。在非手术构建阴道的底部和宫颈下方血肿表面进行切口,将阴道黏膜与血肿的切口边缘缝合。所有患者术后1 - 3个月宫颈出现月经出血。(摘要截断于250字)

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