대표어
한국학술지인용색인(NRF)
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Purpose: Mayer-Rokitansky-Kuster syndrome(MRK) is second common cause of primary amenorrhea. It is a syndrome of vaginal aplasia and Mullerian duct anomaly. Vaginal aplasia varies from agenesis of whole vagina to aplasia of upper 2/3. For reconstructing vagina, various methods are introduced. Gracilis myocutaneous flap was the first attempt in that the flap is used in vaginal reconstruction. Various flap-based vaginal reconstruction methods have been introduced. Modified Singapore flap (pedicled neurovascular pudendal thigh fasciocutaneous flap) is one of those methods that used posterior labial artery as pedicle, and pudendal nerve branch as sensory root. As its donor lies on inguinal crease that is easily hidden and there are benefits on sexual intercourse by early sensory recovery, authors think that modified Singapore flap is effective for young MRK syndrome patients.
Methods: Eight patients underwent surgery between 2008 and 2010. The flap was designed on both groin area with external pudendal artery branch as a pedicle. All flaps were fixated in pelvic cavity with absorbable suture, and additional compression on neovaginal wall was supplied by polyvinyl alcohol sponge(Merocel^ⓡ).
Results: All patients were successfully reconstructed without flap related complications such as congestion or partial flap loss. The average size of the flap(each side) was 69.34cm2. Polyvinyl alcohol sponge(Merocel^ⓡ) was inserted into neovagina for 5 days on every patient. One case of rectal laceration was occurred while making pelvic pocket by OBGY team. Other complications such as lumen narrowing, wound contracture or vaginal prolapsed were not reported during 8 months of follow up.
Conclusion: Modified Singapore flap is a sensate fasciocutaneous flap that is thinner than other myocutaneous flap such as VRAM, and more durable over skin graft. Therefore this is a good choice for vaginal reconstruction in MRK syndrome. And known complications of Modified Singapore flap could be reduced with careful procedure and mild compression techniques.권호기사
참고문헌 (9건) : 자료제공( 네이버학술정보 )
| 번호 | 참고문헌 | 국회도서관 소장유무 |
|---|---|---|
| 1 | The Mayer-Rokitansky-Küster syndrome  |
미소장 |
| 2 | The formation of an artificial vagina without operation |
미소장 |
| 3 | The treatment of congenital absence and obliterative conditions of the vagina. |
미소장 |
| 4 | Vaginal reconstruction with gracilis myocutaneous flaps. |
미소장 |
| 5 | Vaginal Reconstruction with Pudendal Thigh Flaps | 소장 |
| 6 | A New Technique of Vaginal Reconstruction Using Neurovascular Pudendal-Thigh Flaps |
미소장 |
| 7 | Experience with vaginal reconstruction utilizing the modified Singapore flap. |
미소장 |
| 8 | A Comparison of 99 Consecutive Vaginal Reconstructions |
미소장 |
| 9 | Pusic AL, Mehrara BJ: Vaginal reconstruction: an algorithm approach to defect classification and flap reconstruction. J Surg Oncol 94: 515, 2006. | 미소장 |
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