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世界核心医学期刊文摘（胃肠病学分册） 2006年第10期2卷 12-13页

作者： Hassan I. Dozois E.J 刘丽娜 division of colon and rectal surgery Mayo Clinic200 First Street SWRochesterMN 55905United StatesDr

INTRODUCTION: This study was designed to review the clinical characteristics of surgically treated gastrointestinal stromal tumors of the colon and rectum, evaluate their immunohistochemical and pathologic features based on the current National Institutes of Health criteria, and correlate clinicopathologic findings with the subsequent clinical course. METHODS: Patient and disease characteristics at presentation, pathologic features, surgical management, and clinical outcomes of 18 patients with gastrointestinal stromal tumors (4 colon and 14 rectum) diagnosed and primarily treated at our institution between 1979 and 2004 were evaluated. RESULTS: Tumors were classified on basis of size and mitotic rate according to current National Institutes of Health recommendations: 67 percent (n = 12) were high-risk, 5 percent (n = 1) were intermediate-risk, 17 percent (n = 3) were low-risk, and 11 percent (n = 2) were very low-risk gastrointestinal stromal tumors. Fifteen of 18 tumors were KIT-positive. The three KIT-nega- tive tumors were platelet-derived growth factor receptor alpha positive. All patients with colonic gastrointestinal stromal tumors (n = 4) underwent segmental resection, whereas patients with rectal gastrointestinal stromal tumors had local excision (n = 5) or radical resection (n = 9). Sixty-six percent (8/12) of patients with high-risk colorectal gastrointestinal stromal tumors developed metastases. None of the patients (n = 6) with intermediate-risk, low-risk, or very low-risk gastrointestinal stromal tumors died of their disease after a median follow-up of 65 (range, 15-266) months. CONCLUSIONS: The majority of gastrointestinal stromal tumors of the colon and rectum are high-risk. Patients with high-risk colorectal gastrointestinal stromal tumors have a significant likelihood of developing metastases that is associated with poor prognosis. These patients need to be closely followed for an extended period and should be considered for adjuvant therapy with t

关键词：结肠直肠临床过程国立卫生院临床特性受体α 局部切除

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腹壁瘘口生活质量量表

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世界核心医学期刊文摘（胃肠病学分册） 2006年第8期2卷 10-11页

作者： Baxter N. N. Novotny P. J. Jacobson T. T.M. Young-Fadok 纪泛扑(译) 史敏(校) 不详 division of colon and rectal surgery Mayo Clinic 13400 E Shea Blvd Scottsdale AZ 85259 United States

PURPOSE: Few studies have evaluated the impact of a stoma on patient quality of life because of a lack of specific validated measures. This study documents the development and initial application of a Stoma Quality of Life Scale. METHODS: Content experts generated initial questions. Patient focus groups were conducted to ensure that the questions addressed all stoma-related issues considered important by patients. Responses from pilot groups allowed refinement to produce the final measure, the Stoma Quality of Life Scale, a 21- item questionnaire. Three scales are featured: Work/Social Function (6 items), Sexuality/Body Image (5 items), and Stoma Function (6 items). In addition, one item (scored separately) measures financial impact, one measures skin irritation, and two measure overall satisfaction. This questionnaire was administered to 100 consecutive ostomy patients, and readministered three weeks later. Reliability was assessed by using coefficient alpha for internal consistency and intraclass correlation coefficient for test-retest reproducibility. To test validity in extreme groups, scores were compared for patients with improved quality of life vs. those whose stoma worsened their quality of life. To evaluate convergent validity, we analyzed correlation of instrument scales with the SF-12. RESULTS: The Stoma Quality of Life scales demonstrated adequate test-retest reproducibility (intraclass correlation coefficient >0.8) and acceptable internal consistency (coefficient alpha approximately 0.8). The scales were capable of discriminating between patients with better and worse quality of life after stoma formation (P < 0.02 for all scales). The Stoma Quality of Life scales significantly correlated (range, 0.12- 0.75) with the Physical and Mental Health Composite Scale Scores of the SF- 12. CONCLUSIONS: The Stoma Quality of Life Scale demonstrates reasonable psychometric properties for measuring quality of life in patients with stomas. Further studies are needed

关键词：生活质量量表瘘口腹壁患者生活质量影响的研究社会功能相关系数质量改善测试问卷

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Plasma monocyte chemotactic protein-1 remains elevated after minimally invasive colorectal cancer resection

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World Journal of Gastrointestinal Oncology 2014年第10期6卷 413-419页

作者： HMC Shantha Kumara Elizabeth A Myers Sonali AC Herath Joon Ho Jang Linda Njoh Xiaohong Yan Daniel Kirchoff Vesna Cekic Martin Luchtefeld Richard L Whelan division of colon and rectal surgery Department of Surgery Mount Sinai-Roosevelt Hospital Center New York NY 10019 United States division of colon and rectal surgery Fer-guson Clinic Grand Rapids MI 49546 United States Icahn School of Medicine at-Mount Sinai New York NY 10029 United States Surgical Oncology Department of Surgery College of Physicians and Surgeons Columbia University New York NY 10032 United States

AIM: To investigate plasma Monocyte Chemotactic Protein-1 levels preoperatively in colorectal cancer(CRC) and benign patients and postoperatively after CRC ***: A plasma bank was screened for minimally invasive colorectal cancer resection(MICR) for CRC and benign disease(BEN) patients for whom preoperative, early postoperative, and 1 or more late postoperative samples(postoperative day 7-27) were available. Monocyte chemotactic protein-1(MCP-1) levels(pg/mL) were determined via enzyme linked immuno-absorbent assay. RESULTS: One hundred and two CRC and 86 BEN patients were studied. The CRC patient's median preoperative MCP-1 level(283.1, CI: 256.0, 294.3) was higher than the BEN group level(227.5, CI: 200.2, 245.2; P = 0.0004). Vs CRC preoperative levels, elevated MCP-1 plasma levels were found on postoperative day 1(446.3, CI: 418.0, 520.1), postoperative day 3(342.7, CI: 320.4, 377.4), postoperative day 7-13(326.5, CI: 299.4, 354.1), postoperative day 14-20(361.6, CI: 287.8, 407.9), and postoperative day 21-27(318.1, CI: 287.2, 371.6; P < 0.001 for all). CONCLUSION: Preoperative MCP-1 levels were higher in CRC patients(vs BEN). After MICR for CRC, MCP-1 levels were elevated for 1 mo and may promote angiogenesis, cancer recurrence and metastasis.

关键词： Colorectal cancer Monocyte chemotactic protein-1 Minimally invasive colorectal resection angio-genesis

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母亲孕期暴发性溃疡性结肠炎行结肠切除术对其与胎儿的影响:病例系列研究与文献回顾

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世界核心医学期刊文摘（胃肠病学分册） 2006年第6期2卷 20-21页

作者： Dozois E. J. Wolff B. G. Tremaine W. J. 郑世成(译) 王顺涛(校) division of colon and rectal surgery Mayo Clinic 200 First Street SW Rochester MN 55905 United States 不详

PURPOSE: Previous studies have reported high morbidity and mortality in mothers and their offspring after colectomy for ulcerative colitis during pregnancy. This study was designed to assess the maternal and fetal outcomes of pregnant females undergoing colectomy for ulcerative colitis in the current era. METHODS: A retrospective analysis was performed at our institution of all pregnant females undergoing operation for ulcerative colitis between 1980 and 2004. To compare this data to that of past literature, a MEDLINE search from 1951 to 2004 reviewed all cases reported on this topic. RESULTS: Between 1980 and 2004, five females underwent an operation at our institution for fulminant ulcerative colitis while pregnant. All five patients underwent subtotal colectomy with Brooke ileostomy. Postoperative maternal morbidity included a superficial wound infection and a small asymptomatic intra-abdominal abscess. All females had successful pregnancies, and nomaternal or fetal deaths occurred. Two patients went on to have an ileal pouch-anal anastomos is, one had a completion proctectomy and end ileostomy, one is scheduled for an ileal pouch-anal anastomosis, and one patient is lost to follow-up. The literature review revealed 37 cases. The overall fetal and maternal mortality was 49 and 22 percent respectively. Postoperative maternal morbidity was reported in 24 percent. CONCLUSIONS: In contrast to historic data, the maternal and fetal mortality from our series was zero and maternal morbidity was low. Subtotal colectomy and Brooke ileostomy for ulcerative colitis during pregnancy is safe. A multidisciplinary team that includes a gastroenterologist, high-risk obstetrician, and experienced surgeon is necessary for an optimal outcome.

关键词：结肠切除术溃疡性结肠炎母亲孕期文献回顾病例报道暴发性胎儿系列研究 MEDLINE 直肠吻合术

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clinicopathological features of familial adenomatous polyposis in Korean patients

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World Journal of Gastroenterology 2016年第17期22卷 4380-4388页

作者： Sung Min Jung Yong Sik Yoon Seok-Byeong Lim Chang Sik Yu Jin Cheon Kim division of colon and rectal surgery Department of Surgery University of Ulsan College of Medicine Seoul 05505 South Korea Asan Medical Center Seoul 05505 South Korea

AIM: To identify prognostic factors and to correlate APC mutations with clinical features, including extracolic manifestations. METHODS: One hundred thirty-five patients who underwent surgical procedures for familial adenomatous polyposis(FAP) were included. FAP was diagnosed when the number of adenomatous polyps was > 100. Data related to patient, extracoloic manifestations, cancer characteristics, operative procedure, follow up and surveillance were collected. APC mutation testing was performed in the 30 most recent patients. DNA was extracted from peripheral blood and polymerase chain reaction products using 31 primer pairs on APC gene were sequenced. A retrospective study was performed to investigate a causal relationship between prognosis and feature of ***: The mean age of the 51 patients with colorectal cancer(CRC) was older than that of those without CRC(30.5 vs 36.9, P = 0.002). Older individuals were more likely to have colon cancer at the time of FAP diagnosis [odds ratio, 4.75(95%CI: 1.71-13.89) and 5.91(1.76-22.12) for 40-49 years and age > 50 vs age rectal or ileal mucosa after surgery was not observed. The APC mutation testing revealed 23 pathogenic mutations and one likely pathogenic mutation, among which were four novel mutations. The correlation between mutational status and clinical manifestations was investigated. Mutations that could prodict poor prognosis were at codon 1309 which located on mutation cluster region, codon 1465 and codon ***: Identification of APC mutations should aid in the diagnosis and counseling of family members in terms of early diagnosis and management of FAP.

关键词： Adenomatous polyposis coli Colorectal neoplasms APC gene Prognosis Survival

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T1期直肠癌局部切除后的长期生存率

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世界核心医学期刊文摘（胃肠病学分册） 2005年第5期1卷 13-14页

作者： Nascimbeni R. Nivatvongs S. Larson D.R. Burgart L.J. 郝筱倩 division of colon and rectal surgery Mayo Clinic 200 First Street SW Rochester MN 55905 United States Dr.

PURPOSE: Many authors have reported high rates of local recurrence after local excision for early carcinoma of the rectum, which raises the question of whether oncologic resection gives better results. This study was designed to compare the long-term recurrence rate, long-term survival, and risk factors for T1 adenocarcinoma of the rectum treated with local excision or oncologic resection. METHODS: We identified 144 patients who had T1 sessile adenocarcinoma in the lower third or middle third of the rectum. Patients who received adjuvant therapy or who had pedunculated lesions were excluded. Data included age, gender, size of lesion, histologic type of carcinoma, grade, presence of lymphovascular invasion, and depth of invasion. Outcomes were defined as five-year and ten-year cumulative probabilities of local recurrence, distant metastasis, overall survival, and cancer-free survival. The mean follow-up was 9.2 years; median follow-up was 8.1 years. RESULTS: We compared 70 patients who underwent local excision with 74 patients who underwent oncologic resection. Among patients with lesions in the middle or lower third of the rectum, 1) the five-year and ten-year outcomes were significantly better for overall survival and cancer-free survival in the oncologic resection group, but there were no significant differences in local recurrence or distant metastasis; 2) the multivariate risk factors for long-term, cancer-free survival were invasion into the lower third of the submucosa, local excision, and older than aged 68 years; and 3) for lesions with invasion into the lower third of the submucosa, the oncologic resection group had lower rates of distant metastasis and better survival. Among patients with lesions in the lower third of the rectum, 1) the five-year and ten-year outcomes showed no significant differences in survival, local recurrence, or distant metastasis between the two groups; and 2) for lesions with invasion into the lower third of the submucosa, the onco

关键词：局部切除 T1期长期生存率直肠腺癌带蒂肿瘤局部复发率辅助性治疗直肠肿瘤远处转移率肿瘤学

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Current status of laparoscopy for the treatment of rectal cancer

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World Journal of Gastroenterology 2014年第41期20卷 15125-15134页

作者： Noam Shussman Steven D Wexner Department of Colorectal surgery Cleveland Clinic Florida

surgery for rectal cancer in complex and entails many *** the laparoscopic approach in general and specific to colon cancer has been long proven to have short term benefits and to be oncologically safe,it is still a debatable topic for rectal *** attempt to benefit rectal cancer patients with the known advantages of the laparoscopic approach while not compromising their oncologic outcome has led to the conduction of many studies during the past *** we describe our technique for laparoscopic proctectomy and assess the current literature dealing with short term outcomes,immediate oncologic measures(such as lymph node yield and specimen quality) and long term oncologic outcomes of laparoscopic rectal cancer *** also briefly evaluate the evolving issues of robotic assisted rectal cancer surgery and the current innovations and trends in the minimally invasive approach to rectal cancer surgery.

关键词： Laparoscopy rectal cancer Minimally invasive surgery Oncological outcomes Short term benefits

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Correlation between invasive microbiota in margin-surrounding mucosa and anastomotic healing in patients with colorectal cancer

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World Journal of Gastrointestinal Oncology 2019年第9期11卷 717-728页

作者： Yan-Dong Li Kang-Xin He Wei-Fang Zhu division of colon and rectal surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina State Key Laboratory for Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310003Zhejiang ProvinceChina division of Dermatology First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Impaired anastomotic healing is one of the major complications resulting from radical resection in colorectal cancer(CRC).Accumulating evidence suggests that intestinal microbiota is correlated with anastomotic *** To explore the microbiota structural shift in margin-surrounding mucosa and evaluate the predictive ability of selected bacterial taxa for impaired anastomotic *** Margin-surrounding mucosa samples derived from 37 patients were collected to characterize the microbial community structure by 16 s r RNA gene *** patients were divided into two groups according to the healing status of anastomoses:well-healing group(n=30)and impaired-healing group(n=7).Statistic differences in bacteria taxa were compared by Wilcoxon test and chisquared *** predictive ability of the selected bacterial taxa for the healing status of anastomoses was evaluated by the area under the receiver operator characteristic *** Community structure shifts were observed in the impaired-healing group andwell-healing *** bacterial species were found to be significantly correlated with anastomotic healing,and among these species,Alistipes shahii,Dialister pneumosintes,and Corynebacterium suicordis were considered as the predictive *** the known risk factor age into consideration,Alistipes shahii,Dialister pneumosintes,and Corynebacterium suicordis improved predictive ability for the healing status of *** These data show that Alistipes shahii,Dialister pneumosintes,and Corynebacterium suicordis could be considered as supplementary factors in the prediction of anastomosis healing status in patients after CRC radical resection.

关键词： Intestinal microbiota 16s rRNA gene sequencing Anastomotic healing Predictive ability Colorectal cancer Radical resection

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Re-appraisal and consideration of minimally invasive surgery in colorectal cancer

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Gastroenterology Report 2017年第1期5卷 1-10,I0001页

作者： Mahmoud Abu Gazala Steven D.Wexner Department of Colorectal surgery Cleveland Clinic FloridaWestonFLUSA

Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative *** the last three decades,there have been tremendous advances in the field of minimally invasive colorectal surgery,with an explosion of different technologies and approaches offered to treat well-known *** surgery has been shown to be equal or superior to open *** boundaries of laparoscopy have been pushed further,in the form of single-incision laparoscopy,natural-orifice transluminal endoscopic surgery and *** paper critically reviews the pathway of development of minimally invasive surgery,and appraises the different minimally invasive colorectal surgical approaches available to date.

关键词： colon cancer rectal cancer minimally invasive surgery laparoscopy robotic surgery transanal total mesorectal excision natural-orifice specimen extraction

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Nomogram for prediction of pathologic complete remission using biomarker expression and endoscopic finding after preoperative chemoradiotherapy in rectal cancer

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Chinese Journal of Cancer Research 2020年第2期32卷 228-241页

作者： Hyuk Hur Min Soo Cho Woong Sub Koom Joon Seok Lim Tae Il Kim Joong Bae Ahn Hoguen Kim Nam Kyu Kim division of colon and rectal surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoul 03722Korea Department of Radiation Oncology Severance HospitalYonsei University College of MedicineSeoul 03722Korea Departm ent of Radiology Research Institute of Radiological ScienceSeverance HospitalYonsei University College of MedicineSeoul 03722Korea Department of Internal Medicine Institute of Gastroenterology Department of Medical Oncology Severance HospitalYonsei University College of MedicineSeoul 03722Korea Department of Pathology Severance HospitalYonsei University College of MedicineSeoul 03722Korea

Objective:The aim of this study is to develop a nomogram for prediction of pathologic complete remission(p CR)after preoperative chemoradiotherapy(CRT)for rectal ***:m RNA expression levels of seven molecular markers[p53,p21,Ki-67,vascular endothelial growth factor(VEGF),CD133,CD24,CD44]were measured by reverse transcriptase polymerase chain reaction(RTPCR)in 120 rectal *** findings of clinical complete remission(c CR)and biologic variables were used to construct nomogram in the training group(n=80),which was validated in the validation group(n=40).Results:m RNA expression levels of four markers(p53,p21,Ki67,CD133)correlated with p CR(24/80,30.0%)in the training *** expression of p53 and/or high expression of p21,Ki67 and CD133 showed greater p CR rate.p CR was shown in 18(69.2%)of 26 cases showing endoscopic c CR in the training *** p CR rate was demonstrated in lower tumor location than middle tumor(19/49,38.8%vs.5/31,16.1%).A nomogram for prediction of p CR was developed from the multivariate prediction model using these six variables,which showed good discrimination ability in the training group[area under the curve(AUC)=0.945]and validation group(AUC=0.922).The calibration plot showed good agreement between actual and predicted p CR in both patient ***:Nomogram for assessment of p CR can be useful for making treatment decisions after CRT according to predicted responses.

关键词： rectal cancer chemoradiotherapy treatment response molecular marker endoscopy nomogram

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