Vaginal cancer and reconstruction: a 10-year follow-up observation of vaginectomy with genitocrural flap vaginoplasty for primary vaginal carcinoma

摘要

Objective: The incidence rate of vaginal carcinoma is gradually increasing and radical hysterectomy and vaginectomy have become popular treatments to avoid radiation therapy in young patients who wish to retain sexual function after surgery'. Materials and Methods: The authors report a case of 10-year follow-up for primary vaginal carcinoma where vaginectomy with genitocrural flap vaginoplasty were performed to avoid radiation therapy in a young patient. Here, the authors present a case of a 42-year-old female with Stage II vaginal carcinoma who underwent surgery at West China Second University Hospital, Sichuan University, Chengdu, China. She presented with irregular vaginal bleeding, and by gynecological examination, a 4-5cm cauliflower-like nodule in the left lower part of the vaginal wall. After receiving twice neoadjuvant bleomycin and cisplatin chemotherapy with a good response, she underwent radical hysterectomy and vaginectomy with pelvic lymphadenectomy, bilateral ovaries preserved, followed by genitocrural flap that were used for vaginoplasty. Pathology revealed negative margins. After the surgery she was received combination chemotherapy again. Laser therapy was used for hair follicle of genitocrural flap for vaginoplasty and no postoperative infection or necrosis occurred. Results: After a 10-year follow-up observation, the woman did not reveal any local recurrence or distant metastasis and retained sexual function. The very satisfactory anatomical and functional outcome indicates that this technique merits further evaluation. Conclusions: The present authors came to the conclusion that radical hysterectomy and vaginectomy with genitocrural flap vaginoplasty are a reasonable option for patients with primary vaginal carcinoma who wish to retain sexual function after surgery.