THE USE OF VASCULARIZED JEJUNUM FLAP FOR VAGINAL RECONSTRUCTION: CLINICAL EXPERIENCE AND RESULTS IN 22 PATIENTS


ÖZKAN Ö., Akar M. E., ÖZKAN Ö., Colak T., KAYACAN N., Taskin O.

MICROSURGERY, cilt.30, sa.2, ss.125-131, 2010 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 30 Sayı: 2
  • Basım Tarihi: 2010
  • Doi Numarası: 10.1002/micr.20713
  • Dergi Adı: MICROSURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.125-131
  • Akdeniz Üniversitesi Adresli: Evet

Özet

The ideal reconstructive method for a vagina should provide a durable, stable coverage, a patent tube passage for sexual intercourse, and a natural esthetic contour, while simultaneously minimizing morbidity in both the recipient and donor sites, and should be a single stage procedure obviating the use of stents, obturators, and lubrication. Twenty-two patients with absence of the vagina underwent vaginal reconstruction using the jejunal segment transfer technique. Two flaps required re-operation due to venous compromise postoperatively. The flaps were salvaged with venous anastomosis revisions. The overall flap success rate was thus 100%. No urinary tract or gastrointestinal system complication was observed in any case, nor any instance of vaginal introitus. The average follow-up period was 19 months (between 3 and 48 months). Both the depth and diameter of the neovagina were satisfactory postoperatively. After the immediate postoperative period, the only major and embarrassing problem was hypersecretion of the jejunal segment, but this gradually diminished, especially after the first 3 months. Those patients who engaged in sexual intercourse reported good patency and had no complaints in that regard. In conclusion with its evident advantages, the jejunal segment can serve as a reliable option for vaginal reconstruction. It provides quite satisfactory results from both the cosmetic and functional points of view. (C) 2009 Wiley-Liss, Inc. Microsurgery 30:125-131, 2010.