后盆脏器切除带蒂乙状结肠阴道修复术治疗女性直肠癌

匡毅; 李福沛; 蒋又新; 赵和照

doi:10.3969/j.issn.1000-8179.2012.22.040

后盆脏器切除带蒂乙状结肠阴道修复术治疗女性直肠癌

Posterior Pelvic Exenteration and Plastic Operation of Vagina Constituted from the Sigmoid Flexure for Rectal Carcinoma Treatment in Female Patients

摘要

摘要:
目的探讨女性后盆腔脏器切除术后盆底结构重建的方法和意义。
方法 1996年3月至2009年1月重庆市肿瘤研究所行女性后盆腔脏器切除术（posterior pelvic exenteration）49例，其中采用移植带血管蒂乙状结肠作阴道成形，并以大网膜充填骶前间隙，一期缝合会阴切口34例。
结果再造阴道可容两指，长度8~9 cm，壁光滑、柔软、润泽，形体位置与原阴道相近。患者性生活无障碍，膀胱功能良好，无排尿困难。
结论本术式弥补了直肠癌后盆切除术盆底结构缺损处理困难的缺陷，保留患者的性功能，提高了患者术后生存质量。

Abstract:
Objective This work aims to investigate the method and significance of postoperative restitution after pelvic exenteration on female rectal cancer patients.
Methods Since 1996, 49 cases of female rectal cancer underwent posterior pelvic exenteration in the Chongqing Cancer Institute. These patients received plastic operation of the vagina that was constituted from the sigmoid flexure. The pre-sacral space was simultaneously filled by the greater omentum. Primary suture of the perineum was performed in 34 out of 49 cases.
Results The reconstructed vaginas have a width of two fingers, a depth between 8 and 10 cm, and a smooth, soft, and lustrous quality. Their shape and localization were the same as those of the original vaginas, and the patients revealed they have satisfied sexual life and improved bladder function without dysuresia.
Conclusion mThe structural defect of the vagina was eliminated after posterior pelvic exenteration and plastic operation. The sexual function of the vagina was maintained, and the quality of life of the patients improved.

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