【摘要】 目的:探讨减少外阴癌术后切口愈合困难、外阴严重变形、阴道狭窄等并发症的方法。方法:外阴广泛切除术后根据外阴缺损程度游离相应大小带有皮肤、皮下脂肪及供应血管、神经的股薄肌肌皮瓣,在肌皮瓣的供区及受区的皮下软组织内打通一条隧道,将游离好的肌皮瓣通过隧道扭转至外阴缺损区,肌皮瓣近端位于外阴前面耻骨联合处,远端位于外阴后面会阴处,将肌皮瓣与外阴切口的内外缘进行全层缝合。结果:12例患者移植后股薄肌肌皮瓣全部成活,Ⅰ期愈合9例,12例中9例可进行性生活,重建外阴丰满富有弹性,与正常外阴相似。结论:该方法可使外阴癌患者在手术切除肿瘤后获得外阴解剖外观及功能的恢复,缩短了术后康复时间,提高了生活质量,手术方法简单易行,可进行临床推广。更多还原

【Abstract】 Objective: To improve the life quality of patients with vulvar cancer, reduce the distortion or stenosis of vagina and reduce the healing difficulties in radical vulvectomy. Methods: The gracilis muscle was used as skin flap. Two skin flaps with subcutaneous fat were freed and transplanted according to the coloboma size during the radical vulvectomy. Blood vessels and nervi of skin flaps were preserved during freeing and transplanting. Vulva and skin flap were transplanted to coloboma area through a tunnel. Proximal end located arcuate pubic ligament while distal located perineum. All edges were stitched according to hemopoietic tissue contracture. Results: All skin flaps survived and first intention was 9 cases of 12 cases. There were 9 cases that could have sexual life of 10 follow-up survey cases. Reconstructed vulva was similar to normal. Conclusion: Vulviform reconstruction could improve its function and dissection and improve the life quality of patients with vulvar cancer.更多还原