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25 July 2021, Volume 26 Issue 04 Previous Issue    Next Issue

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Editorial

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Retrospect and prospect of Chinese laparoscopic colorectal surgery based on case registry database construction YANG Yingchi, FU Jianning, ZHANG Zhongtao 2021, 26 (04):  277-280.  DOI: 10.16139/j.1007-9610.2021.04.001 Abstract ( 565 )   HTML ( 9 )   PDF (462KB) ( 287 )   References | Related Articles | Metrics

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Surgical platform history of minimally invasive colorectal surgery: evolution from Lancet to electrical equipment ZHUANG Meng, ZHANG Xiaoqian, WANG Xishan 2021, 26 (04):  281-284.  DOI: 10.16139/j.1007-9610.2021.04.002 Abstract ( 317 )   HTML ( 2 )   PDF (520KB) ( 215 )   References | Related Articles | Metrics

Experts forum

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Anastomotic leakage following rectal cancer surgery: risk factors and prevention strategies WEN Xiaofeng, WU Xianrui, LAN Ping 2021, 26 (04):  285-289.  DOI: 10.16139/j.1007-9610.2021.04.003 Abstract ( 368 )   HTML ( 5 )   PDF (508KB) ( 281 )   References | Related Articles | Metrics

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Treatment and combined viscerectomy for locally advanced colorectal cancer GU Jin 2021, 26 (04):  290-296.  DOI: 10.16139/j.1007-9610.2021.04.004 Abstract ( 606 )   HTML ( 15 )   PDF (1732KB) ( 554 )   Figures and Tables | References | Related Articles | Metrics

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Considerations for diagnosis and treatment of colorectal cancer CAI Sanjun 2021, 26 (04):  297-299.  DOI: 10.16139/j.1007-9610.2021.04.005 Abstract ( 234 )   HTML ( 2 )   PDF (378KB) ( 115 )   References | Related Articles | Metrics

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Minimally invasive colorectal cancer surgery: continuous balancing and optimizing between instrument and clinical value ZHANG Tao, YE Feng, ZHAO Ren 2021, 26 (04):  300-304.  DOI: 10.16139/j.1007-9610.2021.04.006 Abstract ( 309 )   HTML ( 3 )   PDF (601KB) ( 134 )   Figures and Tables | References | Related Articles | Metrics

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NOSES in colorectal cancer surgery: current status and prospect YANG Yao, FU Chuangang 2021, 26 (04):  305-311.  DOI: 10.16139/j.1007-9610.2021.04.007 Abstract ( 438 )   HTML ( 9 )   PDF (830KB) ( 254 )   Figures and Tables | References | Related Articles | Metrics

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Interpretation of the 5th edition WHO classification and staging of digestive system tumors: colorectal tumors YU Yingyan 2021, 26 (04):  312-317.  DOI: 10.16139/j.1007-9610.2021.04.008 Abstract ( 1993 )   HTML ( 87 )   PDF (589KB) ( 1582 )   Figures and Tables | References | Related Articles | Metrics

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Imaging in diagnosis of colorectal tumor and evaluation SUN Yingshi, LU Qiaoyuan, GUAN Zhen, Zhang Xiaoyan 2021, 26 (04):  318-324.  DOI: 10.16139/j.1007-9610.2021.04.009 Abstract ( 593 )   HTML ( 7 )   PDF (642KB) ( 394 )   References | Related Articles | Metrics

Original article

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Colorectal cancer incidence and mortality in Shanghai 2016 and trend analysis 2002—2016 WU Chunxiao, GONG Yangming, GU Kai, PANG Yi, BAO Pingping, WANG Chunfang, SHI Liang, XIANG Yongmei, DOU Jianming, FU Chen, SHI Yan 2021, 26 (04):  325-335.  DOI: 10.16139/j.1007-9610.2021.04.010 Abstract ( 609 )   HTML ( 10 )   PDF (1299KB) ( 267 )   Objective To investigate the colorectal cancer (CRC) incidence and mortality in 2016 Shanghai and trend change between 2002 and 2016. Methods Data of CRC incidence and death between 2002 and 2016 were collected from the population-based cancer registry and Vital Statistics System of Shanghai Municipal Center for Disease Control and Prevention. CRC incidence and mortality including year of incidence and mortality, gender, cancer site and age-group were analyzed. CRC incidence and mortality, and proportion, crude rate, age-specific rate, and age-standardized rate were also calculated. Trends of incidence and death of CRC, crude rate, age-specific rate and age-standardized rate were estimated. Trends of gender-standardized CRC incidence and death and the annual percent change(APC) were estimated by Joinpoint analysis. The incidence and proportion of new CRC cases with selected diagnostic character in different years were also calculated. Age-standardized incidence and mortality were calculated using Segi’s 1960 world standard population. Results CRC incidence and mortality were 9 337 and 4 599 in Shanghai 2016. Crude incidence was 64.48/105, and age-standardized rate was 24.64/105. Crude mortality was 31.76/105, and age-standardized rate was 10.13/105. Age-standar-dized incidence and mortality in males were higher than those in females. Age-specific case number and rate and age-specific death number and rate increased with aging. Age-specific case number and rate reached peak at age group both 60-64 years and 80-84 years, and age-specific death number and rate reached peak at age group more than 85 years. Overall, age-standardized CRC incidence between 2002 and 2016 increased 1.07% per year, and age-standardized CRC mortality was stable. Conclusions The current status and trends of CRC stratified by gender or age-group reflect the changes in risk factors, screening test use, and advances in diagnosis and treatment in Shanghai permanent population. Data of population-based cancer incidence and mortality can be used to decrease cancer burden. Figures and Tables | References | Related Articles | Metrics

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Expression of B7S1 related with immune infiltration in colorectal cancer WANG Changgang, LIU Kun, FENG Haoran, JIANG Yimei, SHI Yiqing, CHEN Xianze, SONG Zijia, LI Jun, LI You, CAI Dongli, ZHAO Ren 2021, 26 (04):  336-342.  DOI: 10.16139/j.1007-9610.2021.04.011 Abstract ( 708 )   HTML ( 11 )   PDF (1850KB) ( 167 )   Objective To investigate the expression of B7S1 mRNA which is encoded by VTCN1 and protein levels in colorectal cancer(CRC) with the analysis of relation to clinicopathological characteristics, immune cell infiltration, and prognosis for the evaluation as a immunotherapeutic target in CRC. Methods Both Oncomine and TIMER databases were used to review the expression of VTCN1 in a variety of human solid tumors. The relationship between the expression of VTCN1 and the clinicopathological characteristics of CRC was analyzed using UALCAN and LinkedOmics databases. The expression of VTCN1 which is related with immune infiltration and clinical prognosis was evaluated using Human Protein Atlas database, Kaplan-Meier Plotter and TIMER database. A total of 24 patients with CRC in Ruijin Hospital (North) were collected and the expression of B7S1 protein in both CRC and normal intestinal tissues was detected by immunofluorescence staining. Results It was found in database that VTCN1 was expressed in many human solid tumors. VTCN1 was highly expressed in various subtypes of CRC when compared with that in normal intestinal tissues. The up-regulated VTCN1 was related to tumor stage, lymph node metastasis, distant metastasis, mismatch repair and overall survival rate. VTCN1 was also related to the immune cell infiltration. Immunofluorescence analysis showed that the protein of B7S1 was up-regulated in CRC when compared with that in normal intestinal tissues, and it was expressed in CD45- cells and CD45+ cells. Conclusions As co-inhibitory immune checkpoint molecule, B7S1 may be a potential prognostic factor and might become the target of immunotherapy for CRC. Figures and Tables | References | Related Articles | Metrics

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A comparative study of short-term outcomes of laparoscopic right hemicolectomy with transvaginal specimen extraction without abdominal incisions for radical resection of colon cancer ZHUANG Meng, HU Xiyue, WANG Xishan 2021, 26 (04):  343-347.  DOI: 10.16139/j.1007-9610.2021.04.012 Abstract ( 300 )   HTML ( 6 )   PDF (585KB) ( 75 )   Objective To study the short-term outcomes of laparoscopic right hemicolectomy with transvaginal specimen extraction without abdominal incisions(CRC-NOSES Ⅷ A) for radical resection of colon cancer comparing with laparoscopic right hemicolectomy with transabdominal specimen extraction. Methods Clinical data of the patients with complete laparoscopic right hemicolectomy including 29 cases in transvaginal group and 29 cases in transabdominal group were collected. Comparision between two groups was done for preoperative clinical features, intraoperative indexes, post-operative complications, female sexual function score to charify the impact of the two methods of specimen removal on patients. Results There were no significant differences in intraoperative blood loss, fever and bleeding after operation, intestinal obstruction, anastomotic leakage and other postoperative complications between two groups. Compared with transabdominal group, operative time prolonged [(151.52±33.73) min vs. (179.59±47.02) min, P=0.012 0] and postoperative hospital stay decreased (7.14 d vs. 6.07 d, P=0.013 0) in transvaginal group. The female sexual activity recovered more quickly with less discomfort caused by the scar in transvaginal group and there was no statistical difference in postoperative female sexual function score between two groups. Conclusions CRC-NOSES Ⅷ A could be safe and feasible when compared with conventional laparoscopic hemicolectomy with transabdominal specimen extraction for radical resection of colon cancer. The patients in transvaginal group had less sensation of scars and faster recovery of sexual activity. Figures and Tables | References | Related Articles | Metrics

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Study on carbapenem in preventing infection of severe acute pancreatitis LI Lei, LIU Yiyun, ZHANG Ruyuan, TANG Yaoqing 2021, 26 (04):  348-352.  DOI: 10.16139/j.1007-9610.2021.04.013 Abstract ( 322 )   HTML ( 3 )   PDF (541KB) ( 126 )   Objective To analyze the effects of prophylactic antibiotics on the patients with severe acute pancreatitis (SAP). Methods A total of 139 patients with SAP at Department of Critical Care Medicine, Ruijin Hospital from October 2011 to October 2016 were selected. Forty-eight patients using carbapenem antibiotics were included in this retrospective study after patients with infection of SAP at admission were excluded. Carbapenems were used prophylactically in two groups which included 34 cases in the group used antibiotics within 72 hours onset and 14 cases in the group used after 72 hours onset. The relationship between the time using antibiotic during 72 hours of SAP onset or after 72 hours and prognosis of pancreatic infection in patients with SAP was analyzed. Results There were no statistical differences in mortality at ICU, incidences of both pancreatic infection and extrapancreatic infections, duration of organ failure, and the length of ICU stays between two groups. It was indicated by univariate analysis that the higher incidence of pancreatic infection in patients with early prophylactic antibiotic treatment was related to the higher severity of disease including APACHE Ⅱ score, SOFA score and the higher degree of pancreatic lesions as CT severity index indicated. It was not related to gender, age, and the etiology of pancreatitis. However, there was no factor affected the failure of early prophylactic antibiotic treatment（carbapenem） identified by multivariate analysis. Conclusions It was not shown in this study early prophylactic antibiotic treatment within 72 hours onset can reduce ICU mortality, the incidence of pancreatic infection, and the length of ICU stays in the patients with SAP. For patients with higher severity and higher severe pancreatic lesions, individualized treatment protocols need to be developed. Figures and Tables | References | Related Articles | Metrics

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Prognosis of invasive micropapillary carcinoma versus invasive ductal carcinoma of the breast: a comparative analysis after propensity score matching CHEN Yuanyuan, YE Xin, TANG Yongzhe, WANG Jie, HE Qi 2021, 26 (04):  353-360.  DOI: 10.16139/j.1007-9610.2021.04.014 Abstract ( 622 )   HTML ( 6 )   PDF (949KB) ( 222 )   Objective To investigate the difference in prognosis between invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma(IDC) of the breast and the factors influencing the prognosis of breast carcinoma using propensity score matching (PSM). Methods The retrospective study was performed enrolling the patients with IMPC or IDC in Shanghai Jiao Tong University Breast Cancer Database and the data of clinicopathological characteristics and treatments and follow-up from January 2011 to December 2017. The differences in clinicopathological characteristics and treatments between IMPC and IDC were analyzed. PSM was conducted to balance the confounding factors between IMPC group and IDC group. The difference in prognosis and the factors influencing prognosis of breast carcinoma between two groups after PSM were analyzed. Results A total of 111 cases in IMPC group and 2 865 cases in IDC group were studied. There were more cases in IMPC group who had the expression including estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2, and lymph node metastasis, mastectomy and endocrine therapy when compared those with the cases in IDC group (P<0.05). The rate of breast cancer-free interval (BCFI) in IMPC group was significantly lower than that in IDC group (P=0.022). No significant difference was present in rate of overall survival (OS) between two groups (P=0.268). There were 109 pairs of patients after PSM. The significant difference was not found in clinicopathological characteristics and treatments (P>0.05), and in the rate of BCFI or the rate of OS (P>0.05) between IMPC group and IDC group. It was shown in multivariate analysis of clinicopathological characteristics and treatments that the index of more than 3 positive lymph nodes was an independent risk factor associated with BCFI. Conclusions The prognosis was similar between IMPC and IDC after PSM and the index of more than 3 positive lymph nodes could be an independent risk factor of prognosis. Figures and Tables | References | Related Articles | Metrics

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Study on D-dimer elevation in patients with colorectal cancer MAO Jieqi, XU Duogang, ZHANG Mili, XIAO Yunyu, MING Xu, LI Yuzhe, CAO Can, YU Liang, LI Jikun 2021, 26 (04):  361-366.  DOI: 10.16139/j.1007-9610.2021.04.015 Abstract ( 605 )   HTML ( 3 )   PDF (584KB) ( 118 )   Objective To analyze the association of coagulation with clinical parameters in patients with colorectal cancer. Methods Clinical and pathological data in the patients with colorectal cancer and surgical treatment were collec-ted from August 2018 to December 2019 in the Department of Gastrointestinal Surgery in our hospital. Retrospective analysis was performed to study the related factors to hypercoagulability with preoperative D-dimer value as index. Results A total of 104 from 249 (41.8%) cases exhibited elevated D-dimer (>550 μg/ L) in serum preoperatively. Twenty-seven (10.8%) cases had a significant elevation of D-dimer(>1 650 μg/ L) three times higher than normal limit. There were 7 cases with venous thromboembolism(VTE) postoperatively. Multivariate analysis showed that the preoperative elevated D-dimer in serum was associated with far metastasis and intraluminal invasion. Elevated D-dimer was found 73.3% cases with metastasis and 37.6% cases without metastasis(P<0.01), and 51.9% cases with intraluminal invasion and 34.3% without intraluminal invasion (P<0.01). Far metastasis was seen 2.8% in cases with normal D-dimer, 6.5% with elevated D-dimer, and 22.2% with significantly elevated D-dimer, and intraluminal tumor invasion diagnosed pathologically 35.2%, 48.1% and 66.7% in patients with normal, elevated and significantly elevated D-dimer, respectively. The incidence of VTE was 0.7%, 3.9% and 11.1% in above three groups, which showed the statistical correlation of VTE with preoperative serum D-dimer level. Conclusions Far metastasis and intraluminal tumor invasion are important to induce hypercoagulability state in patients with colorectal cancer and to be as risk predictor of VTE. Figures and Tables | References | Related Articles | Metrics

Clinical research

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Clinical analysis on endovenous laser treatment combined with foam sclerotherapy for lower extremity varicose veins FANG Li, YUAN Hongtao 2021, 26 (04):  367-269.  DOI: 10.16139/j.1007-9610.2021.04.016 Abstract ( 283 )   HTML ( 3 )   PDF (380KB) ( 82 )   References | Related Articles | Metrics

Review

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Diagnosis and treatment of superior mesenteric artery syndrome NI Jiaqi, WU Weize 2021, 26 (04):  370-372.  DOI: 10.16139/j.1007-9610.2021.04.017 Abstract ( 688 )   HTML ( 25 )   PDF (342KB) ( 520 )   References | Related Articles | Metrics