传统腹腔镜腹膜代阴道成形术和腹腔镜单叶腹膜代阴道成形术治疗先天性无阴道疗效比较研究

摘要

目的 对比传统腹腔镜腹膜代阴道成形术和腹腔镜单叶腹膜代阴道成形术治疗先天性无阴道的临床效果.方法 回顾性分析2004年6月至2014年6月河北医科大学第四医院112例先天性无阴道患者的临床资料,其中76例行腹腔镜单叶腹膜代阴道成形术(单叶组),36例行传统腹腔镜腹膜代阴道成形术(传统组).对比2组患者的手术情况、术后阴道情况及性生活满意度.结果 112例手术均获成功,2组患者术后阴道情况及性生活满意度差异无统计学意义(P＞0.05).与传统组相比,单叶组患者的手术时间短[(71.2±19.5) min对(112.2±27.1) min,P=0.02]、术中出血量少(52.8±23.9) mL对(145.6±88.2) mL,P=0.01].结论 尽管两种腹腔镜腹膜代阴道成形术具有相似的临床效果,但腹腔镜单叶腹膜代阴道成形术具有操作简便、手术时间短、术中出血少的优点,更值得推广应用.%Objective To compare the surgical effects of laparoscopic vaginoplasty using single piece of peritoneum and classic laparoscopic peritoneal vaginoplasty in patients with congenital absence of vagina.Methods Between June 2004 and June 2014,the clinical data of 76 patients who underwent laparoscopic vaginoplasty using single piece of peritoneum (SPP group) and 36 patients who underwent classic laparoscopic peritoneal vaginoplasty (classic group) were retrospectively analyzed.The surgical conditions,vagina as well as sexual satisfaction of the two groups were compared.Results All surgical procedures (n=112) were performed successfully.Although the neovagina conditions and sexual satisfaction did not significantly differ between groups (P＞0.05),patients in SPP group had a significantly shorter operative time[(71.2 ± 19.5) min vs.(112.2 ± 27.1) min,P=0.02] and less intraoperative blood loss[(52.8 ± 23.9) mL vs.(145.6 ± 88.2) mL,P=0.01] than those in classic group.Conclusion Although the surgical effects of two laparoscopic peritoneal vaginoplasty techniques are similar,laparoscopic vaginoplasty using single piece of peritoneum,which is easily performed by the gynecologist and has the advantage of shorter operative time and less intraoperative blood loss,is a more feasible and effective approach to create a neovagina in patients with congenital absence of vagina.