OBJECTIVETo evaluate the safety and efficacy of a novel nickel-titanium memory alloy compression anastomosis ring(CAR27) for colorectal anastomosis.

METHODSOne sigmoid cancer patient undergone lower anterior resection(LAR) received colorectal anastomosis with CAR27 on November 12, 2009. The following parameters were recorded during 4 weeks postoperative follow-up:colorectal anastomotic complication,first post-operation flatus and bowel movement, extrusion of ring device.

RESULTSThe total operation time was 42 minutes, including 11 minutes for colorectal anastomosis. The patient had flatus at the first day and began feeding at the second day postoperatively. The ring was expelled with stool at the 10th day postoperatively. Patient didn't have anastomotic complications such as leakage or obstruction during 1 month postoperative follow-up.

CONCLUSIONThis case study primarily indicates CAR27 is safe and feasible for colorectal anastomosis.

Anastomosis, Surgical ; instrumentation ; methods ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Middle Aged ; Nickel ; Rectum ; surgery ; Titanium

Objective To explore the importance and methods of retaining articularis during pri- mary total hip arthroplasty(THA)and reconstruct soft tissue balance of hip joint after THA.Methods From February 2003 to August 2005,41 eases(43 hips)including 19 males and 22 females at age of 46- 80 years(mean 66.5 years)were treated with THA with retained capsule(Group R)and other 42 cases (44 hips)including 20 males and 22 females at age of 43-80 years(mean 64.3 years)with standard THA (Group S).Preoperative diagnosis found femoral neck fractures(GardenⅢⅣ)in 13 cases(13 hips)in Group R and 14(14 hips)in Group S;acetabular dysplasia(CroweⅢ)in 9(9 hips)in Group R and 8 (hips)in Group S;Osteoarthritis in 6(8 hips)in Group R and 7(8 hips)in Group S;and femoral head osteonecrosis(FicatⅢⅣ)in 13(13 hips)in Group R and 13(14 hips)in Group S.There were 13 hips of cement prostheses in Group R and 11 in Group S,8 cementless prostheses in Group R and 8 in Group S, 22 cement and cementless prostheses in Group R and 23 in Group S.Gibson's approach was used in both groups.Group R used the method of retaining capsule and little supination muscles during the operation to reconstruct responsibly soft tissue balancing of postoperation for THA.For comparison,Group S used the method of standard which resected a lots of capsule and didn't reconstruct it.The comparative items between Group R and Group S included incisional length,operative time,operative bleeding,drainage transfusion, infection,dislocation,postoperation standing,postoperation walking and Harris's score.Results All cases in Group R and Group S were followed for 6-22 months(mean 16.5 months in Group R and 16.7 months in Group S).There was significantly statistical difference upon interoperative and postoperative data between Group R and Group S.The result of Group R was significantly better than that of GS.Conclu- sion Retaining articularis during primary THA can minimize operative trauma,reconstruct soft tissue bal- ance and augment hip stability to get postoperative functional recovery.

OBJECTIVETo explore the relationship between CpG island methylator phenotype(CIMP) and genetic instability in sporadic colorectal cancer(SCRC).

METHODSSeventy-one SCRC patients were enrolled in this study. Promotor methylation status of five genes including P14(ARF ), hMLH1, P16(INK4a), MGMT and MINT1 was detected with methylation specific PCR to confirm CIMP. Microsatellite instability (MSI) status was evaluated with two microsatellite loci of BAT25 and BAT26, and the ploidy was detected with flow cytometry. The association between CIMP and MSI as well as chromosomal instability(CIN) was examined.

RESULTSThe positive rates of CIMP, MSI and aneuploidy were 21.1% (15/71), 9.9% (7/71) and 73.5% (50/68) respectively. The positive rate of MSI in positive CIMP patients was higher than that in negative CIMP ones, but the difference was not significant (20.0% vs 7.1%,P=0.158). The positive rate of MSI was 57.1% in patients with hMLH1 gene promotor hypermethylation, which was significantly higher than that (4.7%) in patients without hMLH1 gene promotor hypermethylation (P=0.001). SCRCs with positive CIMP displayed significant inclination of diploidy (P=0.003). The positive rate of diploidy among SCRCs with CIMP was 61.5% while only 18.2% of cases without CIMP demonstrated diploid.

CONCLUSIONSSCRCs with positive CIMP are significantly more likely to be diploid. Simultaneous multiple genes hypermethylation represented by CIMP may be an epigenetic mechanism competing with the genetic mechanism of CIN.

Chromosomal Instability ; Colorectal Neoplasms ; genetics ; CpG Islands ; DNA Methylation ; Genome, Human ; Humans ; Microsatellite Instability ; Phenotype

OBJECTIVETo prospectively evaluate the safety and efficacy of nickel- titanium temperature-dependent memory-shape device(CAR27) for colorectal anastomosis.

METHODSSixty colorectal cancer patients were randomly divided into two groups and received colorectal anastomosis with CAR27 or traditional stapling device. Complications, bowel function return, and the extrusion of anastomosis ring were prospectively monitored.

RESULTSBoth CAR27 and stapler group had one case of anastomotic leakage. Other complications such as stricture or obstruction were not found. Time for anastomosis of the two groups were (10.1±1.2) minutes and (11.2±2.1) minutes respectively. Time to first flatus was(3.2±1.2) days and (3.5±1.4) days respectively. Time to food intake resumption was (4.0±1.4) days and (4.3±1.3) days respectively. The differences above between the two groups were not statistically significant(P>0.05). The ring was expelled with stool within 7-16 days. The two groups were similar in operative time and the return of bowel function.

CONCLUSIONCAR27 is safe and simple for colorectal anastomosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; instrumentation ; Colorectal Neoplasms ; surgery ; Colorectal Surgery ; instrumentation ; Female ; Humans ; Male ; Middle Aged ; Nickel ; Prospective Studies ; Titanium ; Young Adult