[Bowel control of anus-preserving operation for low rectal cancer in elderly patients over 75 years].

OBJECTIVE: To evaluate the bowel control of the anus-preserving operation for elderly patients over 75 years with low rectal cancer. METHODS: Thirty-nine elderly patients over 75 years with low rectal carcinoma (4-7 cm from anal verge) were treated during the study period. The patients were divided into different groups according to the surgical procedures and anastomotic locations. The bowel control and patients satisfaction were compared. RESULTS: The time of recovering normal defecation frequency was (9.8+/- 2.9) months. There were no differences in bowel control and anorectal manometric findings between the lower anastomosis group and super-lower anastomosis group, the lower anastomosis group and anorectal anastomosis group. The patients in anorectal anastomosis group displayed significantly better bowel control and anorectal manometric findings than those in the super-lower anastomosis group (P< 0.05). The time of recovering normal defecation frequency in colonic J-pouch-anal anastomosis group was (7.7+/- 1.7) months, shorter than (10.6+/- 2.8) months in direct anastomosis group (P< 0.01). The complication rate of I degree incontinence was 36.1%, but there was no difference between the two groups. The anorectal manometric findings were better in J-pouch-anal anastomosis group than those in direct anastomosis group (P< 0.05). CONCLUSION: Colonic J-pouch-anal anastomosis for lower rectal carcinoma can significantly improve the bowel control in a short term without increasing the complication rate.

[Bowel control of elderly low rectal cancer patients after anus-retained operation].

BACKGROUND & OBJECTIVE: Though anus-retained operation has became the first choice in radical cure operation for rectal cancer, most surgeons whom fear of dissatisfied bowel control after operation recommend permanent bowel stoma in abdomen for elderly low rectal cancer patients rather than anus-retained operation. This study was to evaluate the bowel control of elderly low rectal cancer patients after anus-retained operation. METHODS: A total of 80 elderly low rectal cancer patients were divided into > or =75-year old group (39 patients) and 60-74-year old group (41 patients). Clinical data and follow-up data of the 80 patients were analyzed; bowel function and continence of the 2 groups were compared. RESULTS: The postoperative 18-month survival rate of all patients was 98.8%. The bowel control statuses of 76 patients were evaluable, of which 36 were in > or =75-year old group, 40 were in 60-74-year old group. Three months after operation, the bowel function was significantly poorer in > or =75-year old group than in 60-74-year old group (P<0.05), but the difference dissolved 6 months after operation (P>0.05). The time of recovering normal defecation frequency was slightly longer in > or =75-year old group than in 60-74-year old group (P>0.05). The prevalence of grade I incontinence 6 months after operation was significantly higher in > or =75-year old group than in 60-74-year old group (36.1% vs. 12.5%, P<0.05), but all symptoms of incontinence were relieved after treatment. CONCLUSIONS: Most elderly low rectal cancer patients could maintain bowel control after anus-retained operation. Age alone should not be a contraindication to a restorative resection for low rectal cancer.

[Establishment of mouse melanoma model expressing beta-galactosidase and its application in the research of DNA vaccines against tumor].

We established a mouse melanoma model expressing beta-galactosidase for the study of tumor immunotherapy. The recombinant vector p3gal was constructed by inserting a beta-galactosidase gene into the MCS of plasmid pcDNA3. The vector then transfected the B16 cells. Through selection with 500 microg/ml G418 and in situ X-Gal staining, the melanoma cell line galB16, stably expressing beta-galactosidase was obtained. The melanoma model was successfully established after inoculation in mouse with galB16 cells. In situ X-Gal staining showed that the tumor cells expressed beta-galactosidase in vivo. With the model, we designed animal experiments for mouse tumor immunotherapy. Twenty mice were randomly assigned to four parallel groups. They received i.m. injection with saline, DNA vaccine p3gal (100 microg/mouse), adjuvant CpG 1826 (20 microg/mouse), or p3gal+CpG 1826 respectively. Our result suggested that the DNA vaccine containing beta-galactosidase gene could protect mice against the galB16 tumor challenge. In addition, when combining with the adjuvant CpG 1826, the effect was increased prominently.