The purpose of this study was to investigate the pathological features and survival of 85 early stage colorectal cancer (CRC) patients who underwent endoscopy followed by radical surgery.

The data of 85 patients who were diagnosis as early stage CRC patient in Cancer Hospital, Chinese Academy of Medical Sciences between Sep.2011 and Sep.2019 were retrospectively collected. The clinicopathological features and survival of the patients were analyzed.

Among the 85 patients, 78 (91.7%) had high risk factors after endoscopic treatment (e.g., the endoscopic resection margin could not be evaluated, the resection margin was positive, the depth of submucosal infiltration was greater than 1 000 μm, the differentiation was poor, accompanied by vascular tumor thrombosis and nerve invasion, etc.). Sixty-six patients (74.2%) had neither residual tumor nor lymph node metastasis after radical resection. One patient (1.2%) had both residual tumor and lymph node metastasis. There were 9 patients (10.6%) with residual tumor. Pathological findings showed lymph node metastasis in another 11 patients (12.9%). Analysis showed that lymph node metastasis was easy to occur under the microscope with pathological accompanied by vascular infiltration (χ²=5.057, P=0.039). The median follow-up time was 24.0 months (P₂₅-P₇₅:12.0~41.1). Among the follow-up patients, two were lost to follow-up, and the remaining 83 patients had no recurrence or metastasis, and all survived.

The treatment of patients with high risk factors after endoscopic resection of early colorectal cancer should be carefully considered. Vascular infiltration may be one of the risk factors for lymph node metastasis. Additional radical surgery is safe and reliable.

To investigate the occurrence and treatment of benign anastomotic stenosis after radical resection of rectal cancer.

Retrospective analysis of the clinical data of 80 patients with benign anastomotic stenosis after rectal surgery at Zhangzhou Affiliated Hospital of Fujian Medical University. Analysis the general situation of patients, preoperative and intraoperative conditions, postoperative complications, anastomotic stenosis treatment process and treatment outcome.

Among the 80 patients with benign anastomotic stenosis, Fifty-six cases (71.8%) of low stenosis, twenty-four cases (18.2%) of high stenosis, fifty-six cases (65.0%) of preventive stoma, thirty-eight cases (47.5%) of postoperative anastomotic leakage and 8 cases (10.0%) of preoperative radiotherapy and chemotherapy. Forty cases (50.0%) were treated with penetrating digital anal expansion, and the cure rate was 85% (34/40); thirty-two patients (40.0%) were dilated by endoscopic balloon, and the median expansion was 2 times (1~4 times), the endoscopic cure rate was 50% (16/32); four cases (5.0%) were lifted after indwelling the nasal canal and 2 case was finally cured; two cases (2.5%) were cured by TEM incision; two patients (2.5%) were cured by intestinal anastomosis after abdominal anastomosis. The total success rate of treatment was 70.0% (56 cases), 30.0% (24 cases) of treatment failure: 58.3% (14/24) of diffuse stenosis, 41.7%(10/24) of tubular stenosis without membranous stenosis. 75% (18/24) had anastomotic leakage; 75.0% (18/24) are low narrowness, 75.0% (18/24) had pelvic infection, eventually the stoma failed and was forced to accept a permanent stoma. There were more anastomotic leakage, non-membranous stenosis, benign concealed stenosis and pelvic infection in the treatment of the failure than in the cured patients, and there were significant differences between the two groups (P<0.05). There were no deaths during the treatment.

The preferred treatment methods for benign anastomotic stenosis after colorectal cancer surgery are anal digital examination and endoscopic treatment, which can obtain better treatment results. The treatment of the failure may be related to anastomotic leakage, non-membranous stenosis, benign concealed stenosis, pelvic infection etc, in clinical work, we should pay attention to the complications and prevent them early.

To evaluate the clinical efficacy of laparoscopic transabdominal rectal prolapse and suspension for the treatment of rectal full-thickness prolapse.

Aretrospective analysis was performed on the data of 32 patients with moderate and severe rectal full-thickness prolapse who underwent laparoscopic transabdominal rectal prolapse and suture fixation from June 2010 to March 2018 in Nanjing Department of Anorectal Surgery, Nanjing University of Traditional Chinese Medicine. Anal rectal pressure measurements, Wexner constipation scores, and Wexner anal incontinence scores were used to evaluate anal function in patients before, 1 month, 3 months, and during follow-up.

Thirty-two patients with full-thickness rectal prolapse underwent laparoscopic transabdominal rectal prolapse and suture fixation under general anesthesia without conversion to open surgery. The operation time was (115.94±23.34) min; the intraoperative blood loss was (20.16±10.74) mL. The hospital stay was (12.84±2.10) d. The VAS score on the day after surgery was (4.56±1.08) points. Thirty-two patients had a good abdominal incision and no complications such as intestinal obstruction and abdominal infection. Of the 32 patients, Thirty-one were successful followed up. The successful rate of follow-up was 96.97% (31/32), and the follow-up time was (47.56±31.29) months. In 31 patients, the cure rate was 90.32% (28/31) after 6 months of surgery. Wexner constipation scores (t=6.135, 10.448, 10.348; all P<0.05) at 1 month, 3 months, and follow-up, and Wexner anal incontinence scores at 1 month, 3 months, and follow-up (t=7.211, 7.789, 10.089; all P<0.05) were all improved compared with preoperative. Twelve patients with rectal prolapse and anal incontinence were more likely to have anal canal pressure (t=-3.477, P<0.05) and anal canal systolic pressure (t=-2.311, P<0.05).

Laparoscopic transrectal rectal prolapse and suspension fixation for the treatment of rectal full-thickness prolapse is significantly improved.

Idiopathic megacolon is an acquired disease of unknown pathogenesis characterized by massive dilatation and aperistalsis of the colon. Idiopathic megacolon typically manifests as abnormal bowel movements, abdominal pain, and bloating. We report a case of adult idiopathic megacolon with intestinal obstruction. Subtotal colectomy and ileostomy were performed for his treatment. Then the diagnosis, differential diagnosis and treatment of adult idiopathic megacolon be discussed.

Natural orifice specimen extraction surgery (NOSES) has been widely used in modern surgical treatment of colorectal cancer. Among them, NOSES for transvaginal specimens of right colon cancer has been proven to be safe and effective, and the trauma is smaller. However, the NOSES of male right colon cancer with transrectal extraction of specimen has not been reported at home and abroad. This article reports a case of total laparoscopic radical surgery for male right colon cancer with transrectal extraction of specimen without auxiliary incision. The aim is to find a way to avoid the auxiliary incision of the abdominal wall for patients with right colon cancer, especially for male patients.

This case report described the process of a rectal cancer patient managed by multidisciplinary team (MDT). The patient was diagnosed as rectal cancer with inguinal lymph nodes metastasis (cT4bN1M1) after initial MDT evaluation. The patient received concurrent XELOX chemotherapy plus local radiotherapy to primary tumor and groin drainage area. The primary lesion was re-evaluated in fifteen weeks post radiation. It was shrinked dramatically and that clinical complete remission (cCR) can not be ruled out. However, a single liver metastatic lesion was newly detected. After further MDT discussion, radiofrequency ablation (RFA) for the liver metastasis was recommended and delivered to the patient. Multiple methods including tumor biomarkers, hepatic MRI and PET-CT showed no evidence of disease in the patient after RFA. The patient is in routine follow-up now. For these rectal cancer patients which achieved cCR in primary lesion after neo-adjuvant chemoradiotherapy, the following decision of radical resection or wait and watch strategy is worthy of further consideration.

We reported the experience of nursing care after tumor resection in a patient with presacral huge tumor and anemia. The key points of nursing after surgery: included the gauze compression measurement was used to pack hemostasis for severe presacral hemorrhage during tumor resection, then the patient was carefully monitored to prevent bleeding when the gauze was removed step by step; meanwhile, personal nursing plan was made to prevent various postoperative complications; additionally, psychological counseling was conducted and reinforced to alleviate fear response. In this paper, we summarized and shared some nursing experience in the process of diagnosis and treatment.

To investigate the normal range and waveform characteristics of rectal electrical stimulation cerebral evoked potential (CEP) in healthy people.

The examiner placed the stimulus electrode in the rectum of the subjects through the anus, the recording electrode at Cz point on the top of the head, the reference electrode at Fz point on the forehead and sampled by Oxford EMP.

Rectal electrical stimulation cerebral evoked potentials were recorded in all subjects. The waveform parameters are P1 wave latency (45.55±3.26) ms, N1 wave (101.71±15.71) ms, P2 wave (198.35±27.70) ms, P1/N1 amplitude (5.62±1.58) μV, N1/P2 amplitude (8.26±2.48) μV. There was no significant difference in latency and amplitude of the evoked potential waves between sex and age groups. By general linear regression analysis, it was found that the amplitude decreased with the increase of BMI after controlling age group and sex. For each increase of BMI of 1 kg/m², the amplitude of P1/N1 decreased by 0.234 μV (P=0.011), and the amplitude of N1/P2 decreased by 0.320 μV (P=0.027).

Rectal electrical stimulation cerebral evoked potentials provides a simple and effective method for evaluating the sensory nerve pathway from rectum to cerebral. This study is of great value in understanding the brain-intestinal interaction in functional gastrointestinal diseases. The results of this study and the analysis of its influencing factors can be used for reference in the follow-up clinical research.