A Rare Cause of Recurrent Melena: Haemangioma of the Small Intestine.

Null.

Difficult Defecation Caused by a Huge Rectal Leiomyoma.

Null.

Billroth-II with Braun versus Roux-en-Y reconstruction in totally laparoscopic distal gastrectomy for gastric cancer.

INTRODUCTION: Totally laparoscopic distal gastrectomy (TLDG) has been increasingly adopted for the treatment of gastric cancer. Both Billroth-II with Braun (B-IIB) reconstruction and Roux-en-Y (R-Y) reconstruction are commonly performed in TLDG; however, which of these reconstruction techniques is better remains unclear. AIM: To compare the efficacy of B-IIB reconstruction and R-Y reconstruction in TLDG for gastric cancer. MATERIAL AND METHODS: A total of 105 gastric cancer patients who underwent TLDG with B-IIB or R-Y reconstruction were reviewed from January 2019 to July 2020. Clinicopathological characteristics and perioperative data of the B-IIB and R-Y groups were compared. RESULTS: Clinicopathological characteristics were not significantly different between the B-IIB and R-Y groups. The average total operative time for the R-Y group (161.9 ±20.7 min) was significantly longer than that for the B-IIB group (141.9 ±16.7 min). The average anastomosis time for the R-Y group (25.5 ±4.1 min) was also significantly longer than that for the B-IIB group (18.9 ±3.3 min). Blood loss volume, number of retrieved lymph nodes, time to first flatus, average length of postoperative hospital stay, inflammatory parameters and postoperative complications did not differ between the two groups. CONCLUSIONS: Both B-IIB reconstruction and R-Y reconstruction are safe and effective in TLDG. B-IIB reconstruction is easier and faster to perform than R-Y reconstruction in TLDG.

CircRASSF2 facilitates the proliferation and metastasis of colorectal cancer by mediating the activity of Wnt/ß-catenin signaling pathway by regulating the miR-195-5p/FZD4 axis.

Circular RNAs (circRNA) are a key regulator of cancer progression, including colorectal cancer (CRC). Nevertheless, the role of circRASSF2 in CRC remains unclear. Quantitative real-time PCR was used to measure the expression of circRASSF2 and miR-195-5p. Cell counting kit 8 assay, colony formation assay, flow cytometry and transwell assay were used to determine the proliferation, apoptosis, migration and invasion of cells, respectively. The levels of proliferation, metastasis and Wnt/ß-catenin signaling pathway-related proteins, as well as Frizzled 4 (FZD4) protein, were determined using western blot analysis. Furthermore, a dual-luciferase reporter assay, RNA immunoprecipitation assay and RNA pull-down assay were used to illumine the mechanism of circRASSF2. Animal experiments were used to determine the role of circRASSF2 in the tumor growth of CRC in vivo. Our study reported that circRASSF2 was upregulated in CRC tissues and cells, and its high expression was related to the poor prognosis of CRC patients. CircRASSF2 knockdown could inhibit proliferation, migration, invasion, and enhance apoptosis in CRC cells, and its overexpression had the opposite effect. Besides, our data revealed that circRASSF2 could sponge miR-195-5p, and miR-195-5p could target FZD4. The rescue experiments indicated that both miR-195-5p inhibitor and FZD4 overexpression could reverse the negative regulation of circRASSF2 silencing on CRC progression. Moreover, circRASSF2 could positively regulate the activity of Wnt/ß-catenin signaling pathway by the miR-195-5p/FZD4 axis. In addition, circRASSF2 knockdown restrained the tumor growth of CRC in vivo. Our findings suggested that circRASSF2 might function as a tumor promoter to accelerate the progression of CRC via regulating the miR-195-5p/FZD4/Wnt/ß-catenin pathway.

Superior Mesenteric and Inferior Mesenteric Artery Diameters in Colorectal Cancer.

OBJECTIVE: To compare the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) diameters in colorectal cancer compared to control. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Taizhou Hospital, Zhejiang University, Taizhou, China, from March 2019 to June 2020. METHODOLOGY: A total of 203 diagnosed colorectal cancer patients and 40 patients as control subjects were reviewed. Patients were divided into three groups based on tumor location as the right colon, left colon, and rectal groups. The diameters were measured on axial computed tomography images independently by two observers. RESULTS: The SMA diameter did not differ between the right colon and control groups (p=0.626). The IMA diameter was significantly higher in the left colon group than in the control group (p=0.002), but there was no significant difference in the IMA diameter between the different tumour stages (p=0.263). The IMA diameter was significantly higher in the rectal group than in the control group (p<0.001). There was a significant increase in the IMA diameter from stage I to stage II rectal cancers (p=0.022) and from stage II to stage III rectal cancers (p=0.003). The IMA diameter did not differ between stage III and IV rectal cancers (p=0.600). In locoregional rectal cancer patients, there was a significant correlation between the IMA diameter and tumour-node-metastasis stage (p<0.001, rs = 0.494). CONCLUSION: Patients with rectal cancer and left colon cancer have a wider IMA diameter than patients without colorectal cancer. IMA diameter can be a potential marker for locoregional staging of rectal cancer. Key Words: Superior mesenteric artery, Inferior mesenteric artery, Colorectal cancer, Markers, Diameter.

Learning curve of totally laparoscopic distal gastrectomy for gastric cancer: a single teaching hospital study.

INTRODUCTION: Totally laparoscopic distal gastrectomy (TLDG) for gastric cancer has gradually gained popularity. However, the learning curve of TLDG is rarely reported. AIM: To determine the learning curve of TLDG for gastric cancer. MATERIAL AND METHODS: We retrospectively reviewed and analyzed the medical records of 80 patients with gastric cancer who underwent TLDG with lymph node dissection from January 2016 to December 2017. We divided the patients into four groups based on when they underwent TLDG: group A (cases 1-20), group B (cases 21-40), group C (cases 41-60), and group D (cases 61-80). Comparative analyses of clinical data, including clinicopathologic characteristics, operative data, and postoperative course, were performed for these groups. RESULTS: No significant difference was observed between the groups in various clinicopathologic characteristics. Total operative time for group A (168.3 ±14.6 min) was significantly longer than for groups B (152.5 ±10.5 min), C (154.2 ±11.6 min), and D (155.3 ±10.8 min), but there was no significant difference between groups B, C, and D. Anastomosis time for group A (27.5 ±12.4 min) was significantly longer than for groups B (15.3 ±4.6 min), C (16.6 ±5.7 min), and D (15.4 ±4.5 min), but there was no significant difference between groups B, C, and D. Non-anastomosis time, estimated blood loss, retrieved lymph nodes, time to first flatus, time to first oral intake, and postoperative hospital stay and complications showed no difference between the four groups. CONCLUSIONS: An experience of approximately 20 cases of TLDG was required to complete the learning curve.

Laparoscopic gastrectomy for gastric cancer in China: an overview.

Since its introduction in China in 2000, laparoscopic gastrectomy has shown classical advantages of minimally invasive surgery over open counterpart. Like all the pioneers of the technique, Chinese gastrointestinal surgeons claim that laparoscopic gastrectomy led to faster recovery, shorter hospital stay and more rapid return to daily activities respect to open gastrectomy while offering the same functional and oncological results. There has been booming interest in laparoscopic gastrectomy since 2006 in China. The last decade has witnessed national growth in the application of laparoscopic gastrectomy and yielded a significant amount of scientific data to support its clinical merits and advantages. However, few prospective randomized controlled trials have investigated the benefits of laparoscopic gastrectomy in China. In this article, we make an overview of the current data and state of the art of laparoscopic gastrectomy for gastric cancer in China.