Prospective study on the use of nickel-titanium temperature-dependent memory-shape device (CAR27) for anastomosis after colorectal surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To prospectively evaluate the safety and efficacy of nickel- titanium temperature-dependent memory-shape device(CAR27) for colorectal anastomosis.</p><p><b>METHODS</b>Sixty colorectal cancer patients were randomly divided into two groups and received colorectal anastomosis with CAR27 or traditional stapling device. Complications, bowel function return, and the extrusion of anastomosis ring were prospectively monitored.</p><p><b>RESULTS</b>Both CAR27 and stapler group had one case of anastomotic leakage. Other complications such as stricture or obstruction were not found. Time for anastomosis of the two groups were (10.1±1.2) minutes and (11.2±2.1) minutes respectively. Time to first flatus was(3.2±1.2) days and (3.5±1.4) days respectively. Time to food intake resumption was (4.0±1.4) days and (4.3±1.3) days respectively. The differences above between the two groups were not statistically significant(P>0.05). The ring was expelled with stool within 7-16 days. The two groups were similar in operative time and the return of bowel function.</p><p><b>CONCLUSION</b>CAR27 is safe and simple for colorectal anastomosis.</p>

Compression anastomosis ring: a novel technique for colorectal anastomosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of a novel nickel-titanium memory alloy compression anastomosis ring(CAR27) for colorectal anastomosis.</p><p><b>METHODS</b>One sigmoid cancer patient undergone lower anterior resection(LAR) received colorectal anastomosis with CAR27 on November 12, 2009. The following parameters were recorded during 4 weeks postoperative follow-up:colorectal anastomotic complication,first post-operation flatus and bowel movement, extrusion of ring device.</p><p><b>RESULTS</b>The total operation time was 42 minutes, including 11 minutes for colorectal anastomosis. The patient had flatus at the first day and began feeding at the second day postoperatively. The ring was expelled with stool at the 10th day postoperatively. Patient didn't have anastomotic complications such as leakage or obstruction during 1 month postoperative follow-up.</p><p><b>CONCLUSION</b>This case study primarily indicates CAR27 is safe and feasible for colorectal anastomosis.</p>

Relationship between CpG island methylator phenotype and genetic instability in sporadic colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between CpG island methylator phenotype(CIMP) and genetic instability in sporadic colorectal cancer(SCRC).</p><p><b>METHODS</b>Seventy-one SCRC patients were enrolled in this study. Promotor methylation status of five genes including P14(ARF ), hMLH1, P16(INK4a), MGMT and MINT1 was detected with methylation specific PCR to confirm CIMP. Microsatellite instability (MSI) status was evaluated with two microsatellite loci of BAT25 and BAT26, and the ploidy was detected with flow cytometry. The association between CIMP and MSI as well as chromosomal instability(CIN) was examined.</p><p><b>RESULTS</b>The positive rates of CIMP, MSI and aneuploidy were 21.1% (15/71), 9.9% (7/71) and 73.5% (50/68) respectively. The positive rate of MSI in positive CIMP patients was higher than that in negative CIMP ones, but the difference was not significant (20.0% vs 7.1%,P=0.158). The positive rate of MSI was 57.1% in patients with hMLH1 gene promotor hypermethylation, which was significantly higher than that (4.7%) in patients without hMLH1 gene promotor hypermethylation (P=0.001). SCRCs with positive CIMP displayed significant inclination of diploidy (P=0.003). The positive rate of diploidy among SCRCs with CIMP was 61.5% while only 18.2% of cases without CIMP demonstrated diploid.</p><p><b>CONCLUSIONS</b>SCRCs with positive CIMP are significantly more likely to be diploid. Simultaneous multiple genes hypermethylation represented by CIMP may be an epigenetic mechanism competing with the genetic mechanism of CIN.</p>