[Single and reduced port laparoscopic surgery for colorectal cancer: current status and future perspectives].

For further maximizing the minimally invasive benefits for colorectal cancer patients, laparoscopic surgeons have been dedicating to improve the surgery through single-port (SILES) or natural orifice transluminal endoscopic surgery (NOTES), which is supported by amount of single-port devices and flexible laparoscopic instruments.Many small sample studies of single institution have suggested that SILES for colorectal cancer has similar oncological outcomes with conventional laparoscopic surgery (CLS), could improve the cosmetic results, and is more minimally invasive than CLS. However, evidences of advantages for SILES are limited, because of there has been only 4 published studies of prospective randomized clinical trial so far. Due to the technical difficulties and long learning curves, SILES and NOTES are relatively hard to be widely promoted. Thus, a balance between minimally invasive pursuit and laparoscopic technical challenge should be sought. In this way, modified SILES and reduced-port laparoscopic surgery have emerged in recent years, which might be minimally invasive solutions with lower technical demanding for laparoscopic colorectal cancer surgeries. Adding a port as the surgeon's dominant operation channel improved the collisions or overlapping of instruments with movement to reduce the technical difficulties. SILS+ 1 is safe and feasible, would be supported by more and more evidences.

[A retrospective controlled clinical study of single-incision plus one port laparoscopic surgery for sigmoid colon and upper rectal cancer].

Objective: To evaluate the short-term and oncologic outcomes of single-incision plus one port laparoscopic surgery (SILS+ 1) for sigmoid colon and upper rectal cancer. Methods: The clinic data of 46 patients with sigmoid colon and upper rectal cancer underwent SILS+ 1 at Department of General Surgery, Nanfang Hospital, Southern Medical University from September 2013 to September 2014 were retrospectively reviewed (SILS+ 1 group). After generating 1∶1 ration propensity scores given the covariates of age, gender, body mass index, American Society of Anesthesiologists score, surgeons, tumor location, the distance of tumor from anal, tumor diameter, and pathologic TNM stage, 46 patients with sigmoid colon and upper rectal cancer underwent conventional laparoscopic surgery (CLS) in the same time were matched as CLS group. The baseline characteristics and short-term outcomes were compared using t test, χ(2) test or Wilcoxon signed ranks test. Kaplan-Meier survival curves and Log-rank tests demonstrated the distribution of disease free survival. Results: The two study groups were well balanced with respect to the baseline characteristics of the propensity score derivation model. As compared to the CLS group, patients in SILS+ 1 group had a smaller incision ((6.9±1.1) cm vs. (8.4±1.2) cm, t=6.502, P=0.000), less estimated blood loss (20(11) ml vs. 50(30) ml, Z=2.414, P=0.016), shorter intracorporeal operating time ((67.0±25.8) minutes vs. (75.5±27.7) minutes, t=2.062, P=0.042) and significantly faster recovery course including shorter time to first ambulation ((46.7±20.3) hours vs. (78.6±28.0) hours, t=6.255, P=0.000), shorter time to first oral diet ((64.7±28.8) hours vs. (77.1±30.0) hours, t=2.026, P=0.047), shorter time of postoperative hospital stay ((7.8±2.2) days vs. (6.5±2.2) days, t=2.680, P=0.009), and lower postoperative visual analogue scale scores (F=4.721, P=0.032). No significant difference was observed in total operating time, postoperative morbidity, first time to flatus and defecation, analgesic use, number of retrieved lymph nodes and resection margin. During the median follow-up period of 33 months (ranging from 7 to 39 months) , there was no significant difference between the two groups in terms of 3-year disease-free survival (SILS+ 1: 91.3%, CLS: 93.4%, P=1.000). The recurrence rates of SILS+ 1 group and CLS groups were 8.7% (4/46) and 6.5% (3/46), respectively. Conclusion: For experienced CLS surgeons, the SILS+ 1 for sigmoid colon and upper rectal cancer would be easiness, safe and efficient alternative.

MiRNA-212 acts as a tumor-suppressor in colorectal carcinoma through targeting SOX4.

OBJECTIVE: Colorectal cancer is a common gastrointestinal cancer, with mortality ranking the third all over the world. MicroRNA-212 (miR-212), located on chromosome 17p13.3, was lowly expressed in a variety of tumors. The purpose of our study was to explore the effects of miR-212 on colorectal cancer (CRC) cells. PATIENTS AND METHODS: Quantitative Real Time-Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blot were employed to evaluate the levels of mRNAs and proteins. The transwell assay was performed to calculate the abilities of migration and invasion. The Luciferase reporter assay was utilized to verify miR-212 targeting to the 3'-UTR of SOX4 mRNA. Statistical analysis was applied to analyze the experimental data. RESULTS: MiR-212 was lowly expressed in CRC tissues and cell lines, while the expression of SRY-box 4 (SOX4) was overexpressed. Exogenous increasing of miR-212 or knockdown of SOX4 inhibited the migration, invasion and epithelial-mesenchymal transition (EMT) in CRC cells. Moreover, the expression of miR-212 had a negative connection with SOX4 expression, and miR-212 mediated the expression of SOX4 by directly binding to the 3'-UTR of SOX4 mRNA. In addition, low expression of miR-212 or overexpression of SOX4 was associated with poor prognosis of colorectal cancer patients. CONCLUSIONS: MiR-212 inhibited the migration, invasion and EMT by direct targeting to the 3'-UTR of SOX4 mRNA in colorectal cancer. The newly identified miR-212/SOX4 axis provides novel insight for colorectal treatment.