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腹腔镜辅助先天性闭锁的新宫颈阴道吻合术和新阴道成形术:一项测量结局和成功率的回顾性研究。

Laparoscopic-assisted neo-cervico-vaginal anastomosis and neo-vagina creation in congenital atresia: A retrospective study measuring the outcome and success.

机构信息

AII India Institute of Medical Sciences, Patna, India.

出版信息

J Plast Reconstr Aesthet Surg. 2024 Mar;90:350-356. doi: 10.1016/j.bjps.2023.09.050. Epub 2023 Oct 21.

Abstract

UNLABELLED

Cervico-vaginal agenesis is a developmental disorder classified as a Mullerian duct anomaly.

STUDY OBJECTIVE

We aimed to study the surgical outcomes of vaginoplasty and laparoscopic-assisted cervical-vaginoplasty carried out using our set-up from June 2016 to December 2022. Additionally, we measured the success of our modified laparoscopy-assisted neo-cervical creation.

DESIGN

A retrospective study.

SETTING

The study was conducted in a tertiary care center and included all patients who underwent vaginoplasty and neo-cervico-vaginal creation using the rail-road method.

PATIENTS

A total of 33 patients were followed-up meticulously and their outcomes were noted. The study was retrospective and largely depended on patient compliance during follow-up.

INTERVENTION

Of the 33 patients, 22 underwent vaginoplasty (McIndoe technique) and 11 underwent neo-cervico-vaginoplasty (rail-road method using both open and laparoscopic methods).

MEASUREMENTS AND MAIN RESULTS

The most common presentation was primary amenorrhea (cyclic abdominal pain with primary amenorrhea) and urinary retention. Four patients underwent hysteroscopy-guided hematometra drainage and none underwent hysterectomy. The average vaginal length measured during the follow-up was 5.2 ± 1.90 cm. Significant symptom relief was observed. Longest follow-up duration was 4.7 years with a mean duration of 210 (180) days.

CONCLUSION

Although the procedure is strenuous, postoperative results showed satisfactory outcomes in improving the quality of life of patients. With expertise in the technique, the associated comorbidity is reduced, which provides relief for the patients.

摘要

未加标签

宫颈阴道发育不全是一种发育障碍,归类为苗勒管异常。

研究目的

我们旨在研究 2016 年 6 月至 2022 年 12 月期间采用我们的方案进行阴道成形术和腹腔镜辅助宫颈阴道成形术的手术结果。此外,我们还测量了我们改良的腹腔镜辅助新颈段创建的成功率。

设计

回顾性研究。

设置

该研究在三级保健中心进行,包括所有采用轨道法进行阴道成形术和新颈阴道成形术的患者。

患者

共对 33 例患者进行了细致的随访并记录了他们的结局。该研究是回顾性的,在很大程度上取决于患者在随访期间的依从性。

干预

33 例患者中,22 例行阴道成形术(McIndoe 技术),11 例行新颈阴道成形术(采用开腹和腹腔镜两种方法的轨道法)。

测量和主要结果

最常见的表现是原发性闭经(周期性腹痛伴原发性闭经)和尿潴留。4 例行宫腔镜引导的积血引流术,无一例行子宫切除术。随访期间平均阴道长度为 5.2±1.90cm。观察到明显的症状缓解。最长随访时间为 4.7 年,平均随访时间为 210(180)天。

结论

尽管手术费力,但术后结果显示,改善患者生活质量的效果令人满意。通过掌握该技术的专业知识,可减少相关并发症,为患者提供缓解。

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