Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation

BACKGROUND Prior studies have shown that preserving the left colic artery(LCA)during laparo-scopic radical resection for rectal cancer(RC)can reduce the occurrence of anasto-motic leakage(AL),without compromising oncological outcomes.However,anatomical variations in the branches of the inferior mesenteric artery(IMA)and LCA present significant surgical challenges.In this study,we present our novel three dimensional(3D)printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.AIM To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.METHODS We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital.Patients were divided into the 3D printing and control groups for sta-tistical analysis of perioperative characteristics.RESULTS The 3D printing observation group comprised of 72 patients,while the control group comprised 68 patients.The operation time(174.5±38.2 minutes vs 198.5±49.6 minutes,P=0.002),intraoperative blood loss(43.9±31.3 mL vs 58.2±30.8 mL,P=0.005),duration of hospitalization(13.1±3.1 days vs 15.9±5.6 days,P<0.001),postoperative recovery time(8.6±2.6 days vs 10.5±4.9 days,P=0.007),and the postoperative complication rate(P<0.05)were all significantly lower in the observation group.CONCLUSION Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively,thereby reducing intraoperative bleeding and shortening operating time,demonstrating better clinical application potential.

Synaptophysin-like 2 expression correlates with lymph node metastasis and poor prognosis in colorectal cancer patients

BACKGROUND Colorectal cancer(CRC)is one of the most common and fatal cancers worldwide.Synaptophysin-like 2(SYPL2)is a neuroendocrine-related protein highly expressed in skeletal muscle and the tongue.The involvement of SYPL2 in CRC,including its level of expression and function,has not been evaluated.AIM To evaluate the correlations of SYPL2 expression with lymph node metastasis(LNM)and prognosis in patients with CRC.METHODS The levels of expression of SYPL2 in CRC and normal colorectal tissues were analyzed in multiple public and online databases.The associations between clinical variables and SYPL2 expression were evaluated statistically,and the associations between SYPL2 expression and prognosis in patients with CRC were analyzed using the Kaplan-Meier method and univariate/multivariate Cox regression analyses.SYPL2 expression was assessed in 20 paired CRC tissue and adjacent normal colorectal tissue samples obtained from Fuyang People’s Hospital,and the associations between SYPL2 expression and the clinical characteristics of these patients were investigated.Correlations between the levels of expression of SYPL2 and key targeted genes were determined by Pearson’s correlation analysis.The distribution of immune cells in these samples was calculated using the CIBERSORT algorithm.Gene set enrichment analysis(GSEA)was performed to evaluate the biofunction and pathways of SYPL2 in CRC.RESULTS SYPL2 expression was significantly lower in CRC tissue samples than in normal colorectal tissue samples(P<0.05).High SYPL2 levels in CRC tissues correlated significantly with LNM(P<0.05)and a poorer patient prognosis,including significantly shorter overall survival(OS)[hazard ratio(HR)=1.9,P<0.05]and disease-free survival(HR=1.6,P<0.05).High SYPL2 expression was an independent risk factor for OS in both univariate(HR=2.078,P=0.014)and multivariate(HR=1.754,P=0.018)Cox regression analyses.In addition,SYPL2 expression correlated significantly with the expression of KDR(P<0.0001,r=0.47)and the BRAFV600E mutation(P<0.05).Higher SYPL2 expression was associated with the enrichment of CD8 T-cells and M0 macrophages in the tumor microenvironment.GSEA revealed that SYPL2 was associated with the regulation of epithelial cell migration,vasculature development,pathways in cancer,and several vital tumor-related pathways.CONCLUSION SYPL2 expression was lower in CRC tissue than in normal colorectal tissue.Higher SYPL2 expression in CRC was significantly associated with LNM and poorer survival.