Nomogram for individually predicting overall survival in rectal neuroendocrine tumours.

BACKGROUND: This study aimed to develop a nomogram that predicts the overall survival (OS) of rectal neuroendocrine tumours (NETs). METHODS: We retrospectively analysed 310 patients with rectal neuroendocrine tumours in 5 hospitals in southern China. All of the patients were assigned to the training set. A multivariable analysis using Cox proportional hazards regression was performed using the training set, and a nomogram was constructed. It was validated on a dataset obtained from the Surveillance, Epidemiology, and End Result (SEER) database of America (n = 547). RESULTS: In the training set, the nomogram exhibited improved discrimination power compared with the WHO grade guidelines (Herrell's C-index, 0.872 vs 0.794; p < 0.001) and was also better than the seventh AJCC TNM classification (Herrell's C-index, 0.872 vs 0.817; p < 0.001). In the SEER validation dataset, the discrimination was also excellent (C-index, 0.648 vs 0.583, p < 0.001 and 0.648 vs 0.603, p = 0.016, respectively, compared with G grade and TNM classification). Calibration of the nomogram predicted individual survival corresponding closely with the actual survival. CONCLUSIONS: We developed a nomogram predicting 1- and 3-year OS of patients with rectal neuroendocrine tumours. Validation revealed excellent discrimination and calibration, suggesting good clinical utility.

Analysis of risk factors of lymph node metastasis in rectal neuroendocrine neoplasms using multicenter data.

AIM: This study was conducted to analyze the risk factors associated with lymph node metastasis in rectal neuroendocrine neoplasms (NENs). MATERIALS & METHODS: A total of 419 patients with rectal NENs were enrolled. A univariate analysis of risk factors of lymph node metastasis was conducted using a χ2 test, and a multivariate analysis was conducted using a logistic regression analysis. RESULTS: Univariate and multivariate regression analysis revealed that tumor size, G grade and the depth of tumor invasion were independent risk factors for lymph node metastasis (p < 0.05). CONCLUSION: Rectal NENs patients with a larger tumor size, deeper tumor invasion or a higher G grade had a higher risk of regional lymph node metastasis.

Total laparoscopic sigmoid vaginoplasty: a novel therapeutic approach.

BACKGROUND: This study aimed to evaluate the technical feasibility and outcomes of total laparoscopic sigmoid vaginoplasty (TLSV) in women with congenital absence of the vagina. METHODS: We investigated 10 women with congenital absence of the vagina, who underwent TLSV at Guangdong Provincial People's Hospital between April 2013 and July 2016. RESULTS: All 10 women were unmarried, the mean age was 22.8 (range 17-33) years, mean estimated blood loss was 149.2 ± 54.8 (60-170) mL, mean operative time was 108.4 ± 52.6 (130-210) min, mean post-operative hospital stay was 8.0 ± 2.8 (6-12) days and the mean neovaginal length was 13.4 ± 3.0 (12-16) cm. Eight of the 10 women were heterosexually active. Trocar port site infection and neovaginal stenosis occurred 3 months after TLSV in one patient; a vaginal mould was used to relieve the stenosis. CONCLUSION: TLSV is an optimal minimally invasive procedure to treat women with congenital absence of the vagina and is associated with rapid recovery and acceptable cosmetic effects.

Reconstruction after LATG: technical tips and pitfalls.

Since the launching of laparoscopic radical gastrectomy in 1990s, the technique of laparoscopy has become more mature, and it has gradually been applied from distal gastrectomy to total gastrectomy. Laparoscopic distal gastrectomy is an accepted option for gastric cancer surgery; however, laparoscopic total gastrectomy is not widely performed, because of the difficulty of reconstruction of the digestive tract. Efforts have been made to establish an intracorporeal anatomic technique for esophagojejunostomy. There have been several techniques for esophagojejunostomy reported using either circular or lineal staplers. This article is to introduce these techniques and try to analysis the technical tips and pitfalls of them.