- 期刊
Transposition of Gracilis Muscle Flap for Treatment of Recurrent Rectovaginal Fistulas Due to Obstetrical Injury
利用股薄肌來重建因産道受傷後的反覆性直腸陰道管
摘要
直腸陰道管對於女性病人而言，不管是在情感上、或是社交上、還是性生活中都是很大的衝擊。傳統的治療方式是由婦産科醫師施行管切除和周邊的健康組織層層縫合。但是很不幸的，常常因爲縫合處張力過於緊張或其他原因面復發直腸陰道管。所以我們用股薄肌來重建這個反覆性直腸陰道管。 從2000年到2003年，我們醫院的4位女位性病人，都是因爲産道生産造成的復發性直腸陰道管。這些復發性的直腸陰道管大小都大於2.5分分，很難再直接縫合傷口。所以我們利用股薄肌細長肌肉的特性及造近陰部管的優勢，來重建這個復發性直腸陰道管的缺損，最後都能治癒。
關鍵字
無資料並列摘要
Rectovaginal fistula, an abnormal epithelium-lined communication between the rectum and vagina, poses a great impact emotionally, socially, and sexually in all affected women. Traditionally, treatment of RVF is excision of the fistula and layer repair of the healthy tissue. However, too much tension around the sutured wound is unpreventable. The fistula recurs eventually. The chief effect of transposing the gracilis muscle is the interposition of well-vascularized, healthy muscle between the rectum and vagina to promote healing of the intractable fistula. From July 2000 to January 2003 at out hospital, four patients following vaginal deliveries endured a complex and recurrent rectovaginal fistula. All of the fistulas were larger than 2.5 cm in size, which were difficult to repair primarily. After fistulectomy was performed, the gracilis muscle flap was transposed to tamponade in the space between vagina and rectum. No colostomy was performed in our all patients. No patients experienced recurrence upon six to eighteen month follow-up. The additional advantages of the gracilis muscle flap for reconstruction of perineal defects is its reliability and long-standing use. It has proved to be a time-honored workhorse for perineal reconstruction. Functional donor site morbidity is minimal, In addition, the long slender shape of the gracilis muscle flap provides the advantage of this muscle to fill the perineal area appropriately.