Landoni F, Proserpio M, Maneo A, Cormio G, Zanetta G, Milani R
III. Clinica Osterica e Ginecologica-Università degli Studi di Milano, Italy.
Aust N Z J Obstet Gynaecol. 1995 Aug;35(3):300-4. doi: 10.1111/j.1479-828x.1995.tb01987.x.
From 1987 to 1990, 72 consecutive patients with primary untreated vulvar cancer underwent radical vulvar surgery with skin flaps reconstruction of the perineal defect. Postoperative complications, anatomical and functional results of this group of patients were compared with those of an historical control group of 77 patients submitted, at the same institution, to radical vulvectomy without reconstructive procedure from 1982 through 1986. The time of operation was significantly longer (180 minutes +/- 15 versus 120 minutes +/- 20) (p = 0.05) for patients submitted to the reconstructive procedure, while there was no statistically significant difference in intraoperative blood loss and hospital stay between the 2 groups. In comparison with direct closure, reconstructive procedures resulted in a significant lower rate of wound dehiscences (26% versus 64%) (p = 0.0001), vaginal introitus stenosis (2 versus 8) (p = 0.0001), sexual dysfunction (10% versus 50%) (p = 0.0001) and misdirection of the urinary stream (1 versus 5) (p = 0.001). It was concluded that skin flaps reconstruction is simple, reduces postoperative morbidity, and provides better anatomical and functional results than direct closure of the perineal defect.
1987年至1990年，72例未经治疗的原发性外阴癌患者连续接受了根治性外阴手术，并采用皮瓣重建会阴缺损。将该组患者的术后并发症、解剖和功能结果与1982年至1986年在同一机构接受根治性外阴切除术且未进行重建手术的77例患者的历史对照组进行比较。接受重建手术的患者手术时间明显更长（180分钟±15分钟对120分钟±20分钟）（p = 0.05），而两组间术中失血量和住院时间无统计学显著差异。与直接缝合相比，重建手术导致伤口裂开率显著降低（26%对64%）（p = 0.0001）、阴道入口狭窄发生率降低（2例对8例）（p = 0.0001）、性功能障碍发生率降低（10%对50%）（p = 0.0001）以及尿流方向异常发生率降低（1例对5例）（p = 0.001）。得出的结论是，皮瓣重建操作简单，可降低术后发病率，并且比直接缝合会阴缺损能提供更好的解剖和功能结果。
