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Expressions of Connexin and Par-3 in the Distal Margin of Rectal Cancer after Ultra-low Anterior Resection
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作者 刘俊 张维康 +4 位作者 刘金林 卢晓明 龙跃平 周颜才 刘胜洪 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2009年第3期330-334,共5页
This study examined the expression of connexin and protease-activated receptor 3 (par-3) in the distal resection margin of rectal cancer and the correlation of the expression of the two proteins with tumor relapse. ... This study examined the expression of connexin and protease-activated receptor 3 (par-3) in the distal resection margin of rectal cancer and the correlation of the expression of the two proteins with tumor relapse. A total of 40 patients with rectal cancer underwent ultra-low anterior resection with curved cutter stapler. The pathological specimens were divided into 3 groups in terms of sampling sites: tumor group, 2.0-cm group (in which the tissues were harvested 2.0 cm distal to the tumor tissues), 3.0-cm group (in which the tissues were taken 3.0 cm away from the tumor tissues). All the samples were pathologically observed and then measured for the expression of connexin and par-3 by employing immunohistochemistry and Western blotting. The operations in this series went uneventfully. No anastomotic stoma bleeding, stenosis and death occurred postoperatively. Histopathologically, in the tumor group, epithelial cells lost normal pattern of arrangement and polarity, and were loosely connected and even detached. In the 3.0-cm group, the epithelia had normal appearance, obvious cell polarity and essentially intact cell junction. Immunohistochemistry and Western blotting indicated that the 3.0-cm group had the strongest expression of connexin and par-3, and the expression in the 2.0-cm group and the tumor group was relatively weak. There existed significant difference in the expression of the two proteins among the three groups (P〈0.05 for all). It was concluded that the down-regulated connexin and par-3 in the distal margin of rectal cancer tissues may indicate the progression of the disease and high likelihood of recurrence and metastasis. Although no tumor cells were found in the sections of the 2.0cm group, the decreased expression of connexin and par-3 may suggest the development of anaplasia and the increased odds of tumor relapse. Therefore, we are led to speculate that tumor resection only including 2.0 cm of unaffected rectum could not completely avoid the distant metastasis and local relapse. 展开更多
关键词 rectal neoplasma curved cutter stapler ultra-low anterior resection protease-activated receptor-3 CONNEXIN
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Transanal natural orifice specimen extraction for laparoscopic anterior resection in rectal cancer 被引量:19
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作者 Fang-Hai Han Li-Xin Hua +2 位作者 Zhi Zhao Jian-Hai Wu Wen-Hua Zhan 《World Journal of Gastroenterology》 SCIE CAS 2013年第43期7751-7757,共7页
AIM: To investigate whether transanal natural orifice specimen extraction (NOSE) is a better technique for rectal cancer resection.METHODS: A prospectively designed database of a consecutive series of patients undergo... AIM: To investigate whether transanal natural orifice specimen extraction (NOSE) is a better technique for rectal cancer resection.METHODS: A prospectively designed database of a consecutive series of patients undergoing laparoscopic low anterior resection for rectal cancer with various tumor-node-metastasis classi?cations from March 2011 to February 2012 at the First Affiliated Hospital of Sun Yat-Sen University was analyzed. Patient selection for transanal specimen extraction and intracorporeal anastomosis was made on the basis of tumor size and distance of rectal lesions from the anal verge. Demographic data, operative parameters, and postoperative outcomes were assessed.RESULTS: None of the patients was converted to laparotomy. Respectively, there were 16 cases in the low anastomosis and five in the ultralow anastomosis groups. Mean age of the patients was 45.4 years, and mean body mass index was 23.1 kg/m2. Mean distance of the lower edge of the lesion from the anal verge was 8.3 cm. Mean operating time was 132 min, and mean intraoperative blood loss was 84 mL. According to the principle of rectal cancer surgery, we performed D2 lymph node dissection in 13 cases and D3 in eight. Mean lymph nodes harvest was 17.8, and the number of positive lymph nodes was 3.4. Median hospital stay was 6.7 d. No serious postoperative complication occurred except for one anastomotic leakage. All patients remained disease free. Mean Wexner score was 3.7 at 11 mo after the operation.CONCLUSION: Transanal NOSE for total laparoscopic low/ultralow anterior resection is feasible, safe and oncologically sound. Further studies with long-term outcomes are needed to explore its potential advantages. 展开更多
关键词 Transanal specimen extraction Natural orifice specimen extraction Laparoscopic anterior resection Low/ultra-low anastomosis Total mesorectal excision
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单吻合器在直肠癌超低位前切除术中的应用 被引量:5
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作者 崔小兵 管郑生 付聿铭 《临床肿瘤学杂志》 CAS 2007年第2期108-111,共4页
目的:探讨单吻合器在直肠癌超低位前切除术(ULAR)中的临床应用效果。方法:对44例单吻合器直肠癌超低位吻合术的临床资料进行回顾性分析。结果:所有病例均顺利接受手术,吻合口距肛缘位置为2.5~4cm,术后肛门控便功能良好,吻合口漏2例(4.5... 目的:探讨单吻合器在直肠癌超低位前切除术(ULAR)中的临床应用效果。方法:对44例单吻合器直肠癌超低位吻合术的临床资料进行回顾性分析。结果:所有病例均顺利接受手术,吻合口距肛缘位置为2.5~4cm,术后肛门控便功能良好,吻合口漏2例(4.5%),无吻合口出血及狭窄,局部复发3例(6.8%),1、3年生存率分别为97.44%、79.48%。结论:单吻合器同样可以完成直肠癌超低位吻合术,且手术效果及肛门功能良好,费用较低。熟练、正确地掌握单吻合器技术操作及提高全直肠系膜切除的手术技巧是手术成败的关键。 展开更多
关键词 单吻合器 直肠癌 超低位前切除术
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Low rectal cancer:Sphincter preserving techniques-selection of patients,techniques and outcomes 被引量:13
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作者 Nikoletta Dimitriou Othon Michail +1 位作者 Dimitrios Moris John Griniatsos 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2015年第7期55-70,共16页
Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity... Low rectal cancer is traditionally treated by abdominoperineal resection. In recent years, several new techniques for the treatment of very low rectal cancer patients aiming to preserve the gastrointestinal continuity and to improve both the oncological as well as the functional outcomes, have been emerged. Literature suggest that when the intersphincteric resection is applied in T1-3 tumors located within 30-35 mm from the anal verge, is technically feasible, safe, with equal oncological outcomes compared to conventional surgery and acceptable quality of life. The Anterior Perineal Plan E for Ultra-low Anterior Resection technique, is not disrupting the sphincters, but carries a high complication rate, while the reports on the oncological and functional outcomes are limited. Transanal Endoscopic Micro Surgery(TEM) and Trans Anal Minimally Invasive Surgery(TAMIS) should represent the treatment of choice for T1 rectal tumors, with specific criteria according to the NCCN guidelines and favorable pathologic features. Alternatively to the standard conventional surgery, neoadjuvant chemo-radiotherapy followed by TEM or TAMIS seems promising for tumors of a local stage T1sm2-3 or T2. Transanal Total Mesorectal Excision should be performed only when a board approved protocol is available by colorectal surgeons with extensive experience in minimally invasive and transanal endoscopic surgery. 展开更多
关键词 Low rectal cancer SPHINCTER preservingsurgery Intersphincteric resection anterior PerinealPlanE for ultra-low anterior resection of the Rectum Total mesorectal EXCISION TRANSANAL Minimally InvasiveSurgery TRANSANAL Total Mesorectal EXCISION Quality oflife Oncological OUTCOME Functional OUTCOME
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