In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

Objective:To identify a new type of hypertrophy of the clitoral hood-labia minora complex(CLC), to propose a classification system for the hypertrophy, and to evaluate surgical techniques and clinical outcomes for fused lateral clitoral hood and labia minora.Methods:A retrospective analysis was conducted on clinical data from patients who underwent labiaplasty surgery at the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital from January 2013 to October 2023. CLC hypertrophy was classified into three types based on whether the CLC was hypertrophic and their free edges fused. Type Ⅰ: isolated labia minora hypertrophy; Type Ⅱ: independent lateral clitoral hood and labia minora hypertrophy; Type Ⅲ: fused type of lateral clitoral hood and labia minora hypertrophy. Type Ⅲ patients were divided into a wedge excision group and a four-step excision group. A satisfaction survey was conducted three months postoperatively using the Goodman female genital aesthetic surgery questionnaire, distributed online to evaluate the surgical outcomes based on vulvar appearance improvement rate, preoperative discomfort improvement rate, postoperative discomfort rate, sexual quality improvement rate, partner satisfaction, and overall satisfaction. Statistical analysis was performed using SPSS 26.0 software, with normal distribution data presented as Mean±SD, intergroup comparisons conducted using t-test, and count data expressed as frequency and(or) percentage with chi-square tests. A P-value < 0.05 was considered statistically significant. Results:A total of 651 female patients (1 243 sides) with CLC hypertrophic deformities were enrolled, aged 18-55 years, with a mean age of 30.7 years. Type Ⅰ consisted of 198 patients with 301 sides(24.22%), Type Ⅱ consisted of 420 patients with 743 sides(59.77%), and Type Ⅲ consisted of 116 patients with 199 sides(16.01%). Some patients had different classifications of CLC on the left and right sides. Among the Type Ⅲ patients, 22 cases were in the wedge resection group and 94 cases in the four-step resection group. Three months postoperatively, 112 patients (195 sides) out of 116 Type Ⅲ patients (199 sides) completed the satisfaction survey. The wedge resection group had 22 patients (44 sides), with an age of (31.6±5.2) years, and the four-step resection group had 90 patients (151 sides), with an age of (32.6±5.5) years. There was no statistically significant difference in age between the two groups ( P>0.05). The four-step resection group had significantly higher vulvar appearance improvement rate [61.11%(55/90) vs. 22.73%(5/22)], preoperative discomfort improvement rate[92.68%(76/82) vs. 58.82%(10/17)], and overall satisfaction [90.00% (81/90) vs. 68.18% (15/22)] compared to the wedge resection group ( P<0.05 for all). The four-step resection group had a sexual quality improvement rate of 21.05%(16/76) and partner satisfaction of 91.14% (72/79), which were not statistically different from the wedge resection group [12.50%(2/16) and 75.00% (12/16)]( P>0.05 for both). The proportion of patients with postoperative discomfort in the four-step resection group was 8.89% (8/90), significantly lower than the 31.82% (7/22) in the wedge resection group ( P< 0.05). There was no statistically significant difference in complication rate between the four-step resection group [2.65% (4/151)] and the wedge resection group [4.55% (2/44)]. Conclusion:CLC hypertrophy can be classified based on clitoral hood and labia minora hypertrophy and fusion type, including isolated labia minora hypertrophy, independent lateral clitoral hood and labia minora hypertrophy, and fused type of lateral clitoral hood and labia minora hypertrophy. The four-step excision method for correcting fused type of lateral clitoral hood and labia minora hypertrophy yields excellent surgical outcomes, low complication rates, and high patient satisfaction.

Objective:To identify a new type of hypertrophy of the clitoral hood-labia minora complex(CLC), to propose a classification system for the hypertrophy, and to evaluate surgical techniques and clinical outcomes for fused lateral clitoral hood and labia minora.Methods:A retrospective analysis was conducted on clinical data from patients who underwent labiaplasty surgery at the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital from January 2013 to October 2023. CLC hypertrophy was classified into three types based on whether the CLC was hypertrophic and their free edges fused. Type Ⅰ: isolated labia minora hypertrophy; Type Ⅱ: independent lateral clitoral hood and labia minora hypertrophy; Type Ⅲ: fused type of lateral clitoral hood and labia minora hypertrophy. Type Ⅲ patients were divided into a wedge excision group and a four-step excision group. A satisfaction survey was conducted three months postoperatively using the Goodman female genital aesthetic surgery questionnaire, distributed online to evaluate the surgical outcomes based on vulvar appearance improvement rate, preoperative discomfort improvement rate, postoperative discomfort rate, sexual quality improvement rate, partner satisfaction, and overall satisfaction. Statistical analysis was performed using SPSS 26.0 software, with normal distribution data presented as Mean±SD, intergroup comparisons conducted using t-test, and count data expressed as frequency and(or) percentage with chi-square tests. A P-value < 0.05 was considered statistically significant. Results:A total of 651 female patients (1 243 sides) with CLC hypertrophic deformities were enrolled, aged 18-55 years, with a mean age of 30.7 years. Type Ⅰ consisted of 198 patients with 301 sides(24.22%), Type Ⅱ consisted of 420 patients with 743 sides(59.77%), and Type Ⅲ consisted of 116 patients with 199 sides(16.01%). Some patients had different classifications of CLC on the left and right sides. Among the Type Ⅲ patients, 22 cases were in the wedge resection group and 94 cases in the four-step resection group. Three months postoperatively, 112 patients (195 sides) out of 116 Type Ⅲ patients (199 sides) completed the satisfaction survey. The wedge resection group had 22 patients (44 sides), with an age of (31.6±5.2) years, and the four-step resection group had 90 patients (151 sides), with an age of (32.6±5.5) years. There was no statistically significant difference in age between the two groups ( P>0.05). The four-step resection group had significantly higher vulvar appearance improvement rate [61.11%(55/90) vs. 22.73%(5/22)], preoperative discomfort improvement rate[92.68%(76/82) vs. 58.82%(10/17)], and overall satisfaction [90.00% (81/90) vs. 68.18% (15/22)] compared to the wedge resection group ( P<0.05 for all). The four-step resection group had a sexual quality improvement rate of 21.05%(16/76) and partner satisfaction of 91.14% (72/79), which were not statistically different from the wedge resection group [12.50%(2/16) and 75.00% (12/16)]( P>0.05 for both). The proportion of patients with postoperative discomfort in the four-step resection group was 8.89% (8/90), significantly lower than the 31.82% (7/22) in the wedge resection group ( P< 0.05). There was no statistically significant difference in complication rate between the four-step resection group [2.65% (4/151)] and the wedge resection group [4.55% (2/44)]. Conclusion:CLC hypertrophy can be classified based on clitoral hood and labia minora hypertrophy and fusion type, including isolated labia minora hypertrophy, independent lateral clitoral hood and labia minora hypertrophy, and fused type of lateral clitoral hood and labia minora hypertrophy. The four-step excision method for correcting fused type of lateral clitoral hood and labia minora hypertrophy yields excellent surgical outcomes, low complication rates, and high patient satisfaction.

Objective:To examine the prognosis factors of postoperative cardiac complications in colorectal cancer patients co-morbidated with coronary artery disease.Methods:Clinical data of 449 patients colorectal cancer patients co-morbidated with coronary artery disease accepted redical surgery from April 2013 to April 2020 at Department of General Surgery, Peking Union Medical College Hospital were analyzed retrospectively. There were 306 males and 143 females, aging (68.7±8.9) years (range: 44 to 89 years). Postoperative acute coronary syndrome, new-onset arrhythmia and heart failure that causes clinical symptoms were recorded as cardiac complications. t test, χ 2 test and Fisher exact test were used for univariate analysis of prognosis factors of postoperative cardiac events. The variables with P<0.05 were included in the multivariate Logistic regression was used to determine the independent prognosis factors. Results:After surgery, 44 patients (9.8%) suffered from at least one cardiac event, including 30 patients with acute coronary syndrome, 19 patients with new-onset arrhythmia and 9 patients with heart failure. There were 3 deaths in the cohort within 30 days after surgery. Two patients died from cardiac-related complications, and one from septic shock due to postoperative anastomotic leaks. On Univariate analysis showed that cardiac complications were associated with age ≥80 years, co-morbidated diabetes, emergency surgery, re-operation, anastomotic leakage, intestinal flora disorder and elevation of preoperative neutrophil-lymphocyte ratio (χ 2: 4.308 to 12.219, all P<0.05). Multivariate Logistic regression analysis identified age ≥80 years ( OR=3.195, 95% CI: 1.379 to 7.407, P=0.007), co-morbidated diabetes ( OR=2.551, 95% CI: 1.294 to 5.025, P=0.007), emergency surgery ( OR=4.717, 95% CI: 1.052 to 20.833, P=0.043), and elevated preoperative neutrophil-lymphocyte ratio ( OR=1.114, 95% CI: 1.018 to 1.218, P=0.018) as independent prognosis factors for cardiac complications. Conclusions:Emergency surgery, advanced age, co-morbidated type 2 diabetes and elevated preoperative neutrophil-lymphocyte ratio may increase the risk of postoperative cardiac complications in colorectal cancer patients with coronary artery disease. Surgeons should strictly master surgical indications, pay attention to preoperative assessment, perioperative monitoring, and diagnosis and treatment of postoperative complications in order to reduce the risk of complications.

Objective:To examine the prognosis factors of postoperative cardiac complications in colorectal cancer patients co-morbidated with coronary artery disease.Methods:Clinical data of 449 patients colorectal cancer patients co-morbidated with coronary artery disease accepted redical surgery from April 2013 to April 2020 at Department of General Surgery, Peking Union Medical College Hospital were analyzed retrospectively. There were 306 males and 143 females, aging (68.7±8.9) years (range: 44 to 89 years). Postoperative acute coronary syndrome, new-onset arrhythmia and heart failure that causes clinical symptoms were recorded as cardiac complications. t test, χ 2 test and Fisher exact test were used for univariate analysis of prognosis factors of postoperative cardiac events. The variables with P<0.05 were included in the multivariate Logistic regression was used to determine the independent prognosis factors. Results:After surgery, 44 patients (9.8%) suffered from at least one cardiac event, including 30 patients with acute coronary syndrome, 19 patients with new-onset arrhythmia and 9 patients with heart failure. There were 3 deaths in the cohort within 30 days after surgery. Two patients died from cardiac-related complications, and one from septic shock due to postoperative anastomotic leaks. On Univariate analysis showed that cardiac complications were associated with age ≥80 years, co-morbidated diabetes, emergency surgery, re-operation, anastomotic leakage, intestinal flora disorder and elevation of preoperative neutrophil-lymphocyte ratio (χ 2: 4.308 to 12.219, all P<0.05). Multivariate Logistic regression analysis identified age ≥80 years ( OR=3.195, 95% CI: 1.379 to 7.407, P=0.007), co-morbidated diabetes ( OR=2.551, 95% CI: 1.294 to 5.025, P=0.007), emergency surgery ( OR=4.717, 95% CI: 1.052 to 20.833, P=0.043), and elevated preoperative neutrophil-lymphocyte ratio ( OR=1.114, 95% CI: 1.018 to 1.218, P=0.018) as independent prognosis factors for cardiac complications. Conclusions:Emergency surgery, advanced age, co-morbidated type 2 diabetes and elevated preoperative neutrophil-lymphocyte ratio may increase the risk of postoperative cardiac complications in colorectal cancer patients with coronary artery disease. Surgeons should strictly master surgical indications, pay attention to preoperative assessment, perioperative monitoring, and diagnosis and treatment of postoperative complications in order to reduce the risk of complications.