先天性无阴道综合征肠道代阴道成形术手术方法介绍和临床结局

先天性无阴道综合征(Mayer-Rokitansky-Küster-Hauser syndrome,MRKH)主要表现为先天性无阴道,发病率为1/4 000～1/5 000。肠道代阴道成形手术是阴道成形方法之一,包括乙状结肠、回肠、直肠、空肠。手术方式包括开腹手术、全腹腔镜手术、腹腔镜辅助下阴道成形手术及无气腹腹腔镜手术。由于腹腔镜技术的相对成熟,现在临床上得到广泛应用,其手术成功率高,成形的人工阴道在形态和功能上都接近正常的阴道,远期效果好,瘢痕较小,患者易于接受。术后并发症发生率较低,包括人工阴道狭窄、肠道吻合口瘘、阴道肠道瘘、人工阴道脱垂、癌变等,通过合理使用人工阴道模具,提高术者操作水平等可降低并发症。

The introduce and clinical outcomes of intestinal vaginoplasty surgery for Mayer - Rokitansky - Kiister - Hauser syndrome

Mayer- Rokitansky- Kiister- Hauser （MRKH） syndrome mainly perform congenital absence of vagina, the incidence rate of which is 1/4 000 - 1/5 000. One of the treatment methods is vaginoplasty surgery using intestinal tract, including sigmoid colon, ileum, rectum, jejunum. Also includes surgical laparotomy, laparoscopic surgery, laparoscopic -assisted surgery and airless laparoscopic vaginoplasty surgery. With the development of laparoscopic surgery, laparoscopic vaginoplasty using intestinal tract are widely used in clinic at present. Laparoscopic vaginoplasty using intestinal tract has a high successful rate and good long - term effect. The artificial vaginas had excellent cosmetic results with appearance and physical functions similar to natural vagina. The incidence of postoperative complications are low, including artificial vaginal stenosis, intestinal fistula, artificial vaginal prolapse and cancer. We can reduce the incidence of postoperative complications with improving the doctors＇ skill and using the vaginal mold correctly.