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Objective To explore the clinical effectiveness of microparticle oral mucosa vaginoplasty.Methods A retrospective analysis was conducted on the clinical data of 149 patients with reproductive tract malformation (MRKH syndrome and vaginal atresia) who required vaginoplasty and were treated at Gansu Provincial Maternal and Child-Care Hospital from February 2013 to January 2024. Patients were divided into three groups based on the surgical method: oral mucosa vaginoplasty group (n=95), peritoneal vaginoplasty group(n=31), and biological patch vaginoplasty group (n=23). Surgical-related indicators, artificial vagina-related indicators, and sexual function indicators were compared to evaluate the clinical effectiveness of microparticle oral mucosa vaginoplasty. Results The oral mucosa group and the biological patch group demonstrated significantly better outcomes in terms of operation time and blood loss compared to the peritoneal group(P

Objective This study aimed to evaluate the psychological health, quality of life, and sexual function in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome treated with biological graft vaginoplasty. Methods This study was a single-center prospective study, including 103 patients diagnosed with MRKH syndrome who underwent biological graft vaginoplasty at Peking Union Medical College Hospital between January 2018 and June 2023. Comprehensive phenotypic assessment information from patients' preoperative outpatient visits, postoperative data from their hospitalization and surgery, follow-up information at 3 months and 1 year postoperatively during outpatient visits,and the relevant questionnaires completed at the 1-year follow-up were collected. A total of 83 patients completed the 1-year follow-up and completed relevant questionnaires under informed consent, including the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7)for psychological health assessment, and the Short Form-12 (SF-12) for quality of life evaluation. Results were compared with general population data from the literature. Sexual function was evaluated at the 1-year follow-up,with 49 patients who had been sexually active in the past 4 weeks completing the Female Sexual Function Index(FSFI) questionnaire.The control group consisted of 49 sexually active, age-matched, and healthy females. Results The mean age of patients was 23.39±6.03 years, with an average postoperative follow-up time of 14.42±3.38 months.At the last follow-up, the mean vaginal length was 7.89±1.28 cm, and the mean vaginal width was 2.95±1.06 cm. One-year postoperatively, patients had significantly higher PHQ-9 scores compared to the general population (P=0.03),while GAD-7 scores showed no significant difference (P=0.5).The SF-12 physical component score(PCS)was significantly lower(P=0.002),whereas the mental component score(MCS)was significantly higher(P

Background and purpose: At present, gastric cancer is still an important cause of cancer death, and its postoperative recurrence is the main factor leading to the low survival rate of gastric cancer. The purpose of this study was to investigate the relationship between early and late postoperative recurrence and metastasis and clinicopathological features in patients with gastric cancer in order to improve the prognosis of gastric cancer. Methods: The clinicopathological data of 188 patients with recurrent and metastatic gastric cancer after radical operation in Zhejiang Cancer Hospital from January 2014 to January 2016 were analyzed retrospectively. The clinicopathological characteristics of patients with early recurrence and metastasis (W2 years) and late recurrence and metastasis (> 2 years) were compared. Results: Among the 188 patients, 126 patients had early recurrence and 62 patients had late recurrence. The overall median time of recurrence was 18 months after operation. Recurrence site, lymph node metastasis, serosa infiltration, no preoperative neoadjuvant chemotherapy, no postoperative adjuvant chemotherapy and poor differentiation are independent risk factors for early postoperative recurrence of gastric cancer. Conclusion: The location of recurrence, preoperative neoadjuvant chemotherapy, postoperative adjuvant chemotherapy, lymph node metastasis, depth of invasion and degree of tissue differentiation are related to postoperative recurrence. [ABSTRACT FROM AUTHOR]

Objective To explore the effectiveness and safety of modified laparoscope-assisted pedicled ileum graft for vaginoplasty. Methods From January 2012 to 2018, 16 patients with congenital absence of vagina or vaginal stenosis after male-to-female transsexual surgery underwent laparoscope-assisted pedicled ileum graft for vaginoplasty. During the operation, a pedicled ileum with sufficient length was cut and transferred into the reconstructed vaginal cavity. A dual triangular flap was designed at the reconstructed vaginal orifice to avoid circular scar contracture. The mold was placed in the reconstructed vagina for 3 to 6 months. Results All patients were followed-up for 6 months to 4 years. The morphology and function of reconstructed vagina was nearly normal in all patients. The depth of reconstructed vagina was 12 cm on average, and could accommodate the columnar prosthesis with a diameter of 4 cm. No obvious postoperative vaginal stenosis and contracture occurred. Conclusion The modified laparoscope-assisted pedicled ileum graft for vaginoplasty had less trauma and good efficacy. It should be considerable for clinical application and promotion. [ABSTRACT FROM AUTHOR]

Objective: To compare the therapeutic effects of two methods of the laparoscopic vaginoplasty using peritoneal and sigmoid colon for those patients with congenital absence of vagina. Methods：The data of 44 patients with congenital absence of vagina undergoing two methods of the laparoscopic vaginoplasty using peritoneal and sigmoid colon in Renmin Hospital of Wuhan University were retrospectively analyzed. Sixteen cases with the laparoscopic peritoneal vaginoplasty were in the peritoneum group, while the laparoscopic auxiliary sigmoid colon vaginoplasty in 28 cases was named as the colon group. The peri-operative situation and post-operative outcomes during follow-up were analyzed. Results：All laparoscopic surgical procedures were successfully completed. There were preponderant outcomes of operating time, anorectum exhaust and blood loss in the peritoneum group when compared with the colon groupx (Ｐ<０.０５). There were not any intraoperative complications in both groups. There were two postoperative complications, intestinal obstruction, in the colon group which recovered after the conservative treatment. During the postoperative follow-up of 6 to 30 months, there were no significantly differences in the length of the reconstructed vagina, width of the reconstructed vagina, various indicators of The Female Sexual Function Index (FSFI) and the total scores of FSFI between the two groups (Ｐ>０.０５). Conclusions：Both methods of laparoscopic vaginoplasty using peritoneal and sigmoid colon can get good therapeutic effect. However, the laparoscopic peritoneal vaginoplasty is more invasive. [ABSTRACT FROM AUTHOR]

Objective: To explore the indication and effectiveness of urogenital sinus surgery in feminizing genitoplasty of disorder of sex development (DSD)., Methods: A retrospective analysis was made on clinical data from 22 patients with DSD who underwent one stage feminizing genitoplasty between October 2010 and December 2015. The patients' age ranged from 1 year and 2 months to 21 years, with the median age of 2 years and 1 month. According to the Prader classification criteria, the appearance of vulvas were rated as grade Ⅰ in 7 cases, grade Ⅱ in 6 cases, grade Ⅲ in 8 cases, and grade Ⅳ in 1 case. Cystoscopy was applied before feminizing genitoplasty in all patients. Low confluence of vagina and urethra was found in 19 patients, while high confluence was found in 3 patients. The mean length of urogenital sinus was 1.6 cm (range, 0.5-3.0 cm). The mean length of water-filled vagina was 4.4 cm (range, 3.5-5.5 cm). Cervix was detected at the end of vagina in 16 patients, meanwhile absence of cervix was detected in 6 patients. The same procedures of clitoroplasty and labioplasty were used in all patients. Three procedures of urogenital sinus surgery were applied, as the "cut-back" vaginoplasty in 6 patients, the "flap" vaginoplasty in 11 patients, and the partial urogenital sinus mobilization (PUM) in 5 patients., Results: All procedures were completed successfully and the incisions healed by stage Ⅰ. All patients were followed up 12-74 months, with the average of 30.5 months. The outcome of appearance evaluation was excellent in 13 patients (59.1%), good in 6 patients (27.3%), and poor in 3 patients (13.6%). Urinary incontinence, post-void residual, urinary infection, and urethrovaginal fistula were not found in 17 toilet trained patients., Conclusion: Urogenital sinus surgery is the most critical step in feminizing genitoplasty of DSD. It can be finished in one stage procedure with clitoroplasty and labioplasty before puberty. If thoroughly evaluation before surgery is completed and the principle of different procedures is handled, the outcome will be satisfactory.