[Perioperative Outcome of Laparoscopic Surgery after Colonic Stent Placement for Obstructive Colorectal Cancer].

In recent years, bridge to surgery(BTS), in which surgery is performed after colorectal stenting for obstructive colorectal cancer, has gradually become popular, and laparoscopic surgery is also a treatment option. From January 2020 to December 2022, we retrospectively evaluated clinicopathological factors in 18 colorectal cancer cases who underwent radical resection after colorectal stenting. We found no difference in patient background, histopathological factors, primary anastomosis rate, stoma creation rate, operative time, postoperative complication rate and length of hospital stay between the laparoscopic surgery(L)and open surgery(O)groups. Blood loss was significantly lower in group L. In T4 patients, laparoscopic surgery after colorectal stenting can be safely performed, but conversion to open surgery may be necessary. Surgery after colorectal stenting should be performed based on preoperative accurate imaging and sufficient experience.

[A Case of Sigmoid Colon Cancer with Retroperitoneal Fibrosis Using Intraoperative Indocyanine Green Fluorescence Angiography for Colorectal Anastomosis].

A 72-year-old man was presented with anemia and diagnosed with sigmoid colon cancer by colonoscopy. CT showed a soft tissue density around the retroperitoneum, leading to the diagnosis of retroperitoneal fibrosis. Stenosis of left ureter, inferior mesenteric artery, and left colic artery due to the soft tissues were detected. Sigmoidectomy and retroperitoneal biopsy were performed, and colorectal anastomosis was completed after confirming the intestinal blood flow by ICG fluorescence angiography. In retroperitoneal fibrosis, identifying blood vessels intraoperatively can be difficult. ICG fluorescence angiography is useful for reliable anastomosis in colorectal cancer surgery with retroperitoneal fibrosis.

[A case of non-curatively resected scirrhous gastric cancer successfully treated over 2 years with weekly administration of paclitaxel].

We report a patient with far-advanced gastric cancer treated by weekly administration of paclitaxel (TXL) over 2 years. The patient was a 66-year-old female with peritoneal metastasis and remarkable lymph node metastasis of scirrhous gastric cancer. She underwent a non-curative resection with total gastrectomy and splenectomy in May 2002. Postoperative chemotherapy with TS-1 (80 mg/body) was performed. Due to grade 4 neutropenia and grade 2 anorexia, this treatment could not be continued. Three months after surgery, the tumor marker (CA19-9) had elevated to an abnormal level. Alternatively, TXL was administered at a weekly dose of 70 mg/m2 for 3 weeks followed by 6 weeks rest from September 2002. The tumor marker (CA19-9) gradually decreased to the normal level. Because of the long rest interval, 10 courses of treatment could be continued, and the patient has been alive over 2 years with the cancer controlled. There have been few effective chemotherapies for gastric cancer with peritoneal metastasis. Weekly paclitaxel therapy is considered to be effective for the treatment of advanced scirrhous gastric cancer with peritoneal metastasis.

mRNA expression of AgSK1, an adenocarconoma-associated antigen, in tumor tissue of patients with colorectal cancer: Quantitative RT-PCR analysis.

PURPOSE: SK1, a human IgM monoclonal antibody recognizes the antigen, termed AgSK1 which was shown to be preferentially expressed by human adenocarcinomas, particularly human gastrointestinal malignancies. The aim of this study was to clarify the clinicopathological significance of AgSK1 mRNA expression in human colorectal cancer. METHODS: Using a quantitative RT-PCR, we studied the mRNA expression level of AgSK1 in the resected specimen of 40 patients with colorectal cancer. We estimated the tumor tissue value (T-value), nontumorous tissue value (N-value), and the ratio of T-value to N-value (T/N Ratio). For further analysis, we compared these data with the clinicopathological features. RESULTS: In the status of lymph node metastases, pN positive status tended to have a higher T-value level of AgSK1 mRNA than pN negative status (P = 0.076). According to a mean T-value (8.032) or a mean T/N Ratio (1.549), we divided these patients into two groups, low expression group and high expression group. A high expression group showed a significantly higher frequency of positive lymph node metastases (T-value; P = 0.021, T/N Ratio; P = 0.024). CONCLUSION: AgSK1 mRNA expression in tumor tissue may become a useful marker for lymph node metastases and a malignant potential marker of colorectal cancer.