Wang Yong,Liang Zijian,Chen Yunpei,et al.Clinical treatment of vaginal replacement with sigmoid colon in children[J].Journal of Clinical Pediatric Surgery,,18():583-587.[doi:10.3969/j.issn.1671-6353.2019.07.013]
Clinical treatment of vaginal replacement with sigmoid colon in children
- Keywords:
- Urogenital Abnormalities; Surgery; Plastic
- CLC:
- R729;R656.9;R699.7
- Abstract:
- Objective To explore the feasibility of vaginal reconstruction with sigmoid colon in children.Methods A total of five children underwent vaginoplasty during 2013-2017.The mean operative age was 21 months and the mean weight 13kg.The initial diagnosis was persistent cloaca (n=4) and congenital vaginal atresia (n=1).Surgery was performed via a simultaneous abdomino-perineal approach.Neovaginal cavity was dissected and sigmoid segment mobilized and transected down to the base of sigmoid arteries.The segment was guided in an iso-peristaltic way through a neovaginal tunnel on to perineum.Distal staple line was opened and sutured to perineum.Results In cloaca cases,operative duration was from 265 to 510 min and intraoperative blood loss 10 to 50 ml.Except for minimal secretion,there was no odor,stenosis or prolapse.Wound healing was excellent.There was no obvious scar tissue.Vaginal length for reconstruction was 6-8 cm.The operative duration of congenital vaginal atresia was 335 min.There was neither odor nor prolapse.Only mild stenosis was present.Pelvic effusion recurred at 1 month post-operation.Cystoscopy indicated an excellent healing of vaginal anastomosis.Suppurative secretion appeared at the junction of uterus and vagina.New vagina was flushed daily until a disappearance of pelvic fluid.Re-examination at 1 year revealed no obvious abnormality.Conclusion With a low incidence of complications,sigmoid colon reconstruction is both safe and effective for children with vaginal malformation.However,a large number of cases are required for long-term follow-up studies.
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Memo
收稿日期:2018-12-15。
基金项目:诱导多能干细胞治疗肠道神经损伤的实验研究（编号：2017070010369）
通讯作者:王勇,Email:summer660@163.com