Clinical Experience of Intracorporeal Hand-sewn Anastomosis Following Totally Laparoscopic Pylorus-Preserving Gastrectomy for Middle-Third Early Gastric Cancer.

INTRODUCTION: Pylorus-preserving gastrectomy (PPG) has been accepted as a representative function-preserving procedure for early gastric cancer (EGC) in the middle stomach. Totally, intracorporeal laparoscopic gastrectomy can provide better aesthetics, be less invasive, and allow faster postoperative recovery. Here, we first describe the surgical procedure of totally laparoscopic pylorus-preserving gastrectomy with intracorporeal hand-sewn anastomosis (TLPPG-IHSA). METHODS: After standard procedure of lymph node dissection and middle stomach resection, we used two double-needle barbed sutures to perform a layer-to-layer manual anastomosis of the anterior and posterior walls in the abdominal cavity. Twelve patients with preoperatively diagnosed clinical EGC located in the middle third of the stomach underwent TLPPG-IHSA between August 2019 and January 2021. RESULTS: A total of 12 patients with EGC successfully underwent TLPPG-IHSA. Only one patient (8.3%) suffered postoperative gastric stasis. No complications or recurrence occurred in other patients during half a year after surgery. CONCLUSION: TLPPG-IHSA is considered technically feasible to treat EGC located in the middle third of the stomach.

Ailanthone: A novel potential drug for treating human cancer.

Cancer is the second leading cause of death after cardiovascular disease. In 2015, >8.7 million people died worldwide due to cancer, and by 2030 this figure is expected to increase to ~13.1 million. Tumor chemotherapy drugs have specific toxicity and side effects, and patients can also develop secondary drug resistance. To prevent and treat cancer, scientists have developed novel drugs with improved antitumor effects and decreased toxicity. Ailanthone (AIL) is a quassinoid extract from the traditional Chinese medicine plant Ailanthus altissima, which is known to have anti-inflammatory and antimalarial effects. An increasing number of studies have focused on AIL due to its antitumor activity. AIL can inhibit cell proliferation and induce apoptosis by up- or downregulating cancer-associated molecules, which ultimately leads to cancer cell death. Antitumor effects of AIL have been observed in melanoma, acute myeloid leukemia, bladder, lung, breast, gastric and prostate cancer and vestibular neurilemmoma. To the best of our knowledge, the present study is the first review to describe the antitumor mechanisms of AIL.

Clinical significance of the molecular heterogeneity of gastrointestinal stromal tumors and related research: A systematic review.

Gastrointestinal stromal tumors (GISTs) are the most commonly observed mesenchymal tumors of the digestive tract, and they originate from the interstitial cells of Cajal. GISTs can be divided into KIT/PDGFRA­mutant GISTs and wild­type GISTs based on the presence or absence of KIT/PDGFRA mutations. Wild­type GISTs can be divided into succinate dehydrogenase complex (SDH)­deficient GISTs and non­SDH­deficient GISTs. Downstream signaling pathways activated by these mutations serve a pivotal role in the development of GISTs and are associated with the biological behavior, including risk stratification, clinical prognosis and drug resistance. Accurate medical care requires accurate molecular diagnosis, which in turn prolongs the survival of patients with GISTs and makes GIST a chronic disease. At present, there is a lack of effective treatment for imatinib/sunitinib/regorafenib resistant patients and KIT/PDGFRA­WT GISTs, which is undoubtedly a major challenge for future research. The present review summarizes the molecular pathogenesis of GISTs and the progress of related research.