[Application of preventive flap-placement of terminal ileostomy in laparoscopic radical resection of low rectal cancer].

Objective: To evaluate the value of preventive flap placement of terminal ileostomy in laparoscopic radical resection of low rectal cancer. Methods: A retrospective analysis was conducted in the patients (n=63) who received preventive terminal ileostomy in laparoscopic radical resection of low rectal cancer in our institution from April 2016 to March 2018, including 33 patients who underwent ileostomy with flap-placement (flap group), and 30 patients who underwent ileostomy with stent (stent group). Clinical data were collected from both groups and statistically analyzed. Results: All patients were successfully completed laparoscopic radical resection with preventive ileostomy. All patients of stent group received stoma-closure surgery one month later after rectal resection. There were significantly statistical differences in operating time of ileostomy (28.9±4.3 vs 36.3±2.3, t=11.73, P<0.001) and overall stoma-related complications (1 vs 7, χ(2)=4.155, P=0.042), but no difference in anastomosis leakage, operating time of stoma-reversal, parastomal infection, parastomal hernia and parastomal prolapse. Conclusions: Preventive flap placement of terminal ileostomy represents a secure and feasible approach to laparoscopic low rectal cancer resection. Patients can be released from the discomfort of removing the stent and may suffer fewer stoma-related complications.

[Clinical effect of preservation of the left colonic artery in laparoscopic anterior resection for rectal cancer].

Objective: To evaluate the value and feasibility of preservation of the left colonic artery (LCA) in laparoscopic anterior resection for rectal cancer. Methods: The clinical data of 97 patiens who received laparoscopic anterior resection of rectal cancer from 2009.3 to 2015.3 were randomly divided into two groups, including 52 cases with preservation of LCA and 45 cases without preservation of LCA. The operation time, quantity of bleeding, number of lymph nodes removed around the root of inferior mesenteric artery (IMA), the rate of lymph node metastasis around the root of IMA, the incidence of transverse colostomy and anastomotic leak were compared between the two groups. Results: All 97 operations were successfully completed by laparoscopic operation. There were significantly statistical differences in operation time, quantity of bleeding and transverse colon stoma between two groups(P<0.05), but no difference in the number of lymph nodes removed and the rate of lymph node metastasis. Conclusions: The preservation of the left colonic artery in laparoscopic anterior resection of rectal cancer can preserve more supplying vessels for anastomosis and prevent anastomotic leak.

[Value of serum CA 19-9 determination in the diagnosis of pancreatic carcinoma].

In this communication, serum Ca19-9 was determined in a series of patients with benign and malignant GI diseases. It was found that CA19-9 was positive in 86.7% of 30 pancreatic cancer patients with an average level of 427.53 u/ml, the value was statistically different from that found in non-malignant control group. Serum CA19-9 determination, in this series, helped to make definite diagnosis of pancreatic cancer in 6 cases, in which B-mode ultrasonography failed to diagnose, and in another 3 cases in which CT scanning was unable to 'see' the tumors. The combination of CA19-9, B-mode ultrasonography, and CT made definite diagnosis in 100% of all 30 pancreatic cancer patients. The authors discussed the significance of CA19-9 determination in the diagnosis and differential diagnosis of pancreatic cancer.

[Intraoperative radiotherapy of unresectable pancreatic carcinoma].

During the period from 1986 to 1991, 33 patients with unresectable carcinoma of the pancreas received intraoperative radiotherapy (IORT). Abdominal and back pain which tormented all patients before IORT totally disappeared in 18 patients (54%) and was allevrited in 13 patients (40%). The average survival time of 6.5 months for patients treated with IORT was not statistically different from that of 30 patients with resectable pancreatic cancers undergoing resection. IORT hence is a good palliative therapy for unresectable carcinoma of the pancreas.

Expression of 32-kDa laminin-binding protein mRNA in colon cancer tissues.

Colorectal cancer initiation and progression are associated with stepwise genetic alterations. We and others have shown that a gene encoding for a 32-kDa putative laminin-binding protein (LBP-32) is overexpressed during colorectal cancer progression by Northern blots analysis. Northern blots cannot indicate the heterogeneity of expression from cell to cell and the distribution pattern of gene expression within a given tumor. In order to overcome these problems, we examined the LBP-32 mRNA expression in colorectal carcinomas by in situ hybridization. LBP-32 mRNA expression in 30 cases of primary and metastatic colorectal cancers and their respective adjacent normal tissues were detected by in situ hybridization using 35S-UTP radiolabeled antisense riboprobes. The results showed that LBP-32 mRNA was expressed at a low level in the normal colonic mucosa adjacent to the tumor compared with colon cancer tissues. Its expression in poorly differentiated colorectal cancer was much higher than that in well- and moderately differentiated colorectal cancer. More importantly, the LBP-32 mRNA was expressed more highly in the invasive lesions of the cancer and liver metastases compared with the cancer lesions in situ. Our results imply that in situ hybridization is a powerful tool in evaluating the changes in gene expression in the cancer cells and LBP-32 mRNA expression is related to progression, invasion, and metastasis of colorectal cancer.