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Clinical outcome of intersphincteric resection for ultra-low rectal cancer

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World Journal of Gastroenterology 2006年第4期12卷 640-643页

作者： Chih-ChienChin Wen-ShihHuang Jeng-YiWang Chien-Yuh Yeh Division of colon and rectal surgery Changgung Memorial HospitalPutzu 613TaiwanChina Division of colon and rectal surgery Changgung Memorial HospitalLin-kou 333TaiwanChina

AIM： To analyze oncological outcome of intersphincteric resection （ISR） in ultra-low rectal cancer with intent to spare colostoma. METHODS： From 1995 to 1998, patients with a nonfixed rectal adenocarcinoma （tumor stage T2） preserving the lower margin at 1-3 cm above the dentate line without distant metastasis was enrolled （period I）. ISR was practiced in eight patients, and their postoperative followup was at least 5 years. In addition, from 1999 to 2003, another 10 patients having the same tumor location as period Ⅰ underwent ISR （period Ⅱ）. Among those, 6 patients with T3-4-staged tumor received preoperative chemoradiotherapy. RESULTS： All patients received ISR with curative intention and no postoperative mortality. In these case series at period Ⅰ, local recurrence rate was 12.5% and metastasis rate 25.0%; the S-year survival rate was 87.5% and disease-free survival rate 75.0%. There was no local recurrence or distant metastases in 10 patients with a median follow-up of 30 （range, 18-47） mo at period Ⅱ. CONCLUSION： As to ultra-low rectal cancer, intersphincteric resection could provide acceptable local control and cancerrelated survival with no permanent stoma in early-staged tumor （tumor stage T2）; more- over, preoperative concurrent chemoradiotheraw would make ISR feasible with surgical curative intent in more advanced tumors （tumor stages T3-4）.

关键词： Intersphincteric resection Ultra-low rectal cancer

Predictors of complications after prophylactic ileostomy reversal for rectal cancer:A retrospective study

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World Journal of Gastrointestinal surgery 2024年第5期16卷 1354-1362页

作者： Quan Lv Xin-Peng Shu Dong Peng Si-Qi Li Zheng Xiang department of Gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Chongqing Key Laboratory of department of General surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

BACKGROUND Previous studies have analyzed the risk factors for complications after ileostomy reversal for rectal cancer(RC),but there were significant differences in the reported risk factors for complications after stoma *** studies have analyzed the risk factors for stoma-related complications and overall postoperative com-plications *** To analyze the risk factors for overall complications and stoma-related complications after ileostomy reversal for patients with *** This was a retrospective study of 439 patients who underwent ileostomy reversal at a clinical center and were followed up between September 2012 and September *** variables are expressed as the mean±SD and were analyzed with independent-sample t tests,while frequency variables are expressed as n(%),and theχ2 test or Fisher’s exact test was *** and multivariate logistic regression analyses were used to identify predictors of overall complications and stoma-related *** The overall complication rate after ileostomy reversal was 11.4%.Patients with lower preoperative albumin concentration(Psurgery to ileostomy reversal(Psurgery to ileostomy reversal(P<0.01,OR=1.140,95%CI:1.038-1.252)were independent risk factors for stoma-related compl

关键词： Ileostomy Reversal Risk factors Complications rectal cancer

Postoperative changes of manometry after restorative proctocolectomy in Korean ulcerative colitis patients

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World Journal of Gastroenterology 2017年第31期23卷 5780-5786页

作者： se heon oh yong sik yoon jong lyul lee chan wook kim in ja park seok-byung lim chang sik yu jin cheon kim department of surgery division of colon and rectal surgery university of ulsan college of medicine asan medical center

To investigate the changes of postoperative anal sphincter function and bowel frequency in Korean patients with ulcerative colitis (UC). METHODSA total of 127 patients with UC who underwent restorative proctocolectomy (RPC) during 20 years were retrospectively analyzed. The parameters of anal manometry and bowel frequency were compared according to the 6-mo intervals until 24 mo postoperatively. Manometry was used to measure the maximal squeezing pressure (MSP) and maximal resting pressure (MRP). RESULTSMSP decreased after surgery until 6 mo (157 to 142 mmHg); thereafter, it improved and was recovered to and maintained at the preoperative value at 12 mo postoperatively (142-170 mmHg, P rectal capacity after surgery (90 to 82 mL) gradually increased up to 150 mL at 24 mo. Although bowel frequency showed significant gradual decreases at each interval, it was stabilized after 12 mo postoperatively (6.5 times/d). CONCLUSIONPostoperative changes of manometry and bowel frequency after restorative proctocolectomy in Korean patients with UC were not different from those in Western patients with UC.

关键词： Ulcerative colitis surgery Treatment outcome Manometry Bowel frequency Restorative proctocolectomy

Evaluating bacterial contamination and surgical site infection risks in intracorporeal anastomosis: Role of bowel preparation

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World Journal of Gastrointestinal surgery 2024年第6期16卷 1953-1955页

作者： Junho Lee department of surgery Hanyang UniversityCollege of MedicineSeoul 04763South Korea

We recently read the study by Kayano et al on intracorporeal anastomosis(IA)for colon cancer,which assessed bacterial contamination and medium-term onco-logical outcomes and affirmed that IA is analogous to extracorporeal anastomosis in reducing intraperitoneal bacterial risk and achieving similar oncological *** commentary addresses gaps,particularly concerning bowel preparation and surgical site infections(SSIs),and highlights the need for comprehensive details on the bowel preparation methods that are currently employed,including mecha-nical bowel preparation,oral antibiotics(OA),their combination,and specific OA *** emphasize the necessity for further analyses that investigate these me-thods and their correlation with SSI rates,to enhance clinical protocol guidance and optimize surgical *** meticulous analyses are essential for refi-ning strategies to effectively mitigate SSI risk in colorectal surgeries.

关键词： Intracorporeal anastomosis Surgical site infection Mechanical bowel preparation Oral antibiotics Bacterial contamination colon cancer

UPLC-Q-TOF/MS-Based Serum Metabolomics Reveals Potential Anti-tumor Mechanism of Banxia Xiexin Decoction in Colorectal Cancer Mice

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Chinese Journal of Integrative Medicine 2024年第7期30卷 623-632页

作者： YUE Yin-zi LI Ming-xuan WANG Xiao-hui QIN Yuan-yuan WANG Ya-hui TAN Jin-hua SU Lian-lin YAN Shuai department of General surgery Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou215009China School of Pharmacy Nanjing University of Chinese MedicineNanjing210023China department of General surgery Bayinguoleng Mongolian Autonomous Prefecture People’s HospitalXinjiang Uygur Autonomous RegionKorla841000China department of Pharmacy Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou215009China department of Anorectal surgery Suzhou TCM Hospital Affiliated to Nanjing University of Chinese MedicineSuzhou215009China

Objective To clarify the potential mechanism of Banxia Xiexin Decoction(BXD)on colorectal cancer(CRC)from the perspective of *** Forty male C57BL/6 mice were randomly divided into normal control(NC),azoxymethane/dextran sulfate sodium(AOM/DSS)model,low-dose BXD(L-BXD),high-dose BXD(H-BXD)and mesalamine(MS)groups according to a random number table,8 mice in each *** cancer model was induced by AOM/*** was administered daily at doses of 3.915(L-BXD)and 15.66 g/kg(H-BXD)by gavage for consecutive 21 days,and 100 mg/kg MS was used as positive *** the entire modeling cycle,colon length of mice was measured and quantity of colorectal tumors were *** spleen and thymus index were determined by calculating the spleen/thymus weight to body *** cytokine and changes of serum metabolites were analyzed by enzyme-linked immunosorbent assay kits and ultra performance liquid chromatography-quadrupole/time-of-flight mass spectrometry(UPLC-Q/TOF-MS),*** Notably,BXD supplementation protected against weight loss,mitigated tumor formation,and diminished histologic damage in mice treated with AOM/DSS(P<0.05 or P<0.01).Moreover,BXD suppressed expression of serum inflammatory enzymes,and improved the spleen and thymus index(P<0.05).Compared with the normal group,102 kinds of differential metabolites were screened in the AOM/DSS group,including 48 potential biomarkers,involving 18 main metabolic *** 18 potential biomarkers related to CRC were identified,and the anti-CRC mechanism of BXD was closely related to D-glutamine and D-glutamate metabolism,phenylalanine,tyrosine and tryptophan biosynthesis,arginine biosynthesis,nitrogen metabolism and so *** BXD exerts partial protective effects on AOM/DSS-induced CRC by reducing inflammation,protecting organism immunity ability,and regulating amino acid metabolism.

关键词： colorectal cancer metabolomics ultra performance liquid chromatography-quadrupole/time-of-flight mass spectrometry azoxymethane dextran sulfate sodium Banxia Xiexin Decoction Chinese medicine

Clinical outcome and prognostic factors of T4N0M0 colon cancer after R0 resection:A retrospective study

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1869-1877页

作者： Bang Liu Zhao-Xiong Zhang Xin-Yang Nie Wei-Lin Sun Yong-Jia Yan Wei-Hua Fu department of General surgery Tianjin Medical University General HospitalTianjin Medical UniversityTianjin 300052China

BACKGROUND Paradoxically,patients with T4N0M0(stage II,no lymph node metastasis)colon cancer have a worse prognosis than those with T2N1-2M0(stage III).However,no previous report has addressed this *** To screen prognostic risk factors for T4N0M0 colon cancer and construct a prognostic nomogram model for these *** Two hundred patients with T4N0M0 colon cancer were treated at Tianjin Medical University General Hospital between January 2017 and December 2021,of which 112 patients were assigned to the training cohort,and the remaining 88 patients were assigned to the validation *** between the training and validation groups were *** training cohort was subjected to multi-variate analysis to select prognostic risk factors for T4N0M0 colon cancer,followed by the construction of a nomogram *** The 3-year overall survival(OS)rates were 86.2%and 74.4%for the training and validation cohorts,***(P=0.000),T stage(P=0.001),right hemicolon(P=0.025),irregular review(P=0.040),and carbohydrate antigen 199(CA199)(P=0.011)were independent risk factors of OS in patients with T4N0M0 colon cancer.A nomogram model with good concordance and accuracy was *** Enterostomy,T stage,right hemicolon,irregular review,and CA199 were independent risk factors for OS in patients with T4N0M0 colon *** nomogram model exhibited good agreement and accuracy.

关键词： T4N0M0 colon cancer Prognosis Multivariate analysis Nomogram colon cancer

Pan-immune-inflammation value as a prognostic biomarker for colon cancer and its variation by primary tumor location

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World Journal of Gastroenterology 2024年第33期30卷 3823-3836页

作者： Qian-Yu Wang Wen-Tao Zhong Yi Xiao Guo-Le Lin Jun-Yang Lu Lai Xu Guan-Nan Zhang Jun-Feng Du Bin Wu department of General surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Medical department of General surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China

BACKGROUND A growing body of research indicates significant differences between left-sided colon cancers(LCC)and right-sided colon cancers(RCC).Pan-immune-inflammation value(PIV)is a systemic immune response marker that can predict the prognosis of patients with colon ***,the specific distinction between PIV of LCC and RCC remains *** To investigate the prognostic and clinical significance of PIV in LCC and RCC *** This multicenter retrospective cohort study included 1510 patients with colon cancer,comprising 801 with LCC and 709 with *** used generalized lifting regression analysis to evaluate the relative impact of PIV on disease-free survival(DFS)in these ***-Meier analysis,as well as univariate and multivariate analyses,were used to examine the risk factors for *** correlation between PIV and the clinical characteristics was statistically analyzed in these *** A total of 1510 patients{872 female patients(58%);median age 63 years[interquartile ranges(IQR):54-71];patients with LCC 801(53%);median follow-up 44.17 months(IQR 29.67-62.32)}were *** was significantly higher in patients with RCC[median(IQR):214.34(121.78-386.72)vs 175.87(111.92-286.84),P227.84)was associated with worse DFS in LCC[PIV-high:Adjusted hazard ratio(aHR)=2.39;95%confidence interval:1.70-3.38;Pcolon cancer biomarker.

关键词： colon cancer Left-sided colon cancer Right-sided colon cancer Pan-immune-inflammation value Systemic inflammatory biomarkers Prognosis

Intestinal endometriosis:Diagnostic ambiguities and surgical outcomes

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World Journal of Clinical Cases 2019年第4期7卷 441-451页

作者： Jun Woo Bong Chang Sik Yu Jong Lyul Lee Chan Wook Kim Yong Sik Yoon In Ja Park Seok-Byung Lim Jin Cheon Kim Division of colon and rectal surgery Department of SurgeryUniversity of Ulsan College of Medicine and Asan Medical Center

BACKGROUND Endometriosis is a common disease for women of reproductive age. However,when it involves intestines, it is difficult to diagnose preoperatively because its symptoms overlap with other diseases and the results of evaluations can be unspecific. Thus it is important to know the clinical characteristics of intestinal endometriosis and how to exactly *** To analyze patients in whom intestinal endometriosis was diagnosed after surgical treatments, and to evaluate the clinical characteristics of preoperatively misdiagnosed *** We retrospectively reviewed the pathologic reports of 30 patients diagnosed as having intestinal endometriosis based on surgical specimens between January2000 and December 2017. We reviewed their clinical characteristics and surgical *** Twenty-three(76.6%) patients showed symptoms associated with endometriosis,with dysmenorrhea being the most common(n = 9, 30.0%). Thirteen patients(43.3%) had a history of pelvic surgeries. Ten patients(33.3%) had a history of treatment for endometriosis. Only 4 patients(13.3%) had a diagnosis of endometriosis based on endoscopic biopsy findings. According to preoperative evaluations, 13 patients(43.3%) had an initial diagnosis of pelvic endometriosis and 17 patients(56.6%) were misdiagnosed as having other diseases. The most common misdiagnosis was submucosal tumor in the large intestine(n = 8, 26.7%),followed by malignancies of the colon/rectum(n = 3, 10.0%) and ovary(n = 3,10.0%). According to the Clavien-Dindo classification, 5 complications were grade I or II and 2 complications were grade IIIa. The median follow-up period was 26.9(0.6-132.1) mo, and only 1 patient had a recurrence of *** Intestinal endometriosis is difficult to diagnose preoperatively because it mimics various intestinal diseases. Thus, if women of reproductive age have ambiguous symptoms and signs with nonspecific radiologic and/or endoscopic findings,intestinal endometriosis sho

关键词： Endometriosis Intestinal endometriosis Diagnosis surgery Treatment

The impact of surgeon choices on costs associated with uncomplicated minimally invasive colectomy:you are not as important as you think

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Gastroenterology Report 2018年第2期6卷 108-113,I0002页

作者： John Tillou Deborah Nagle Vitaliy Poylin Thomas Cataldo Division of colon and rectal surgery Department of SurgeryBeth Israel Deaconess Medical CenterBostonMAUSA

Background:There is increasing public discussion about the escalating cost of healthcare in *** are no published data regarding the contribution of individual surgeons’choices on the cost of uncomplicated minimally invasive ***:A review of a hospital cost-accounting database of the direct costs related to the index operation and postoperative care of all patients who underwent elective minimally invasive segmental colectomy over a 1-year period was ***:A total of 111 cases were enrolled in this study,18 of which were performed *** average direct cost after minimally invasive colectomy was$*** cost of robotic colectomy was 53%greater than laparoscopic($7806 vs$5096,p<0.001).There was no statistically significant difference in overall costs among laparoscopic cases performed by three surgeons($5099 vs$5108 vs$5055,p¼0.987).Average operating room supply costs among the three surgeons were$1236,$1105 and$1030,respectively(p¼0.067),with a standard deviation of$328(6.4%of overall cost).Conclusions:No significant difference in overall costs between surgeons was demonstrated despite varied training,experience levels and operative *** costs are relatively institutionally fixed and minimally influenced by variations in individual surgeon preferences.

关键词： cost minimally invasive colectomy laparoscopy individual surgeon