Objective:To explore the safety and feasibility of circular-stapled anastomosis using purse-string suture device with multi-functional seal cap in totally laparoscopic total gastrectomy esophagojejunostomy.Methods:This technique is based on a new purse-string suture device and multi-functional seal cap. After laparoscopic total gastrectomy and D2 dissection, the purse-string suture device was inserted into the abdominal cavity through the multi-functional sealing cover and placed in a proper position along the distal esophagus for formation of purse-string suture. Anvils were introduced inside the purse-string after its fire, and a 25-mm cicular stapler was inserted to the abdominal cavity through the multi-functional seal cap, following laparoscopic end-to-side circular-stapled esophagojejunostomy.Results:From November 2024 to December 2024, three patients with gastric cancer underwent laparoscopic total gastrectomy with D2 lymphadenectomy and successfully accepted laparoscopic esophagojejunostomy based on the purse-string suture device with multi-functional seal cap. The operation time was 180 minutes, 260 minutes and 240 minutes, respectively with the time of anvil pacement of 4 minutes,4 minutes, 4.5 minutes for the three cases. The bleeding volume of each was 100 ml respectively. The proximal esophageal margins were 2 cm from the tumor, and the margins were negative for tumor. No extravasation of contrast agent was seen in the postoperative oral contrast anastomosis. All three patients were followed up for 33, 30, and 25 days after the operation, and no anastomotic bleeding, leakage, or other related complications were found.Conclusion:The circular anastomosis using purse-string suture device with multi-functional seal cap in totally laparoscopic total gastrectomy esophagojejunostomy is safe and feasible, which is a promising novel choice for laparoscopic radical treatment of gastric cancer with total gastrectomy oesophagojejunostomy.

Objective:To explore the safety and feasibility of circular-stapled anastomosis using purse-string suture device with multi-functional seal cap in totally laparoscopic total gastrectomy esophagojejunostomy.Methods:This technique is based on a new purse-string suture device and multi-functional seal cap. After laparoscopic total gastrectomy and D2 dissection, the purse-string suture device was inserted into the abdominal cavity through the multi-functional sealing cover and placed in a proper position along the distal esophagus for formation of purse-string suture. Anvils were introduced inside the purse-string after its fire, and a 25-mm cicular stapler was inserted to the abdominal cavity through the multi-functional seal cap, following laparoscopic end-to-side circular-stapled esophagojejunostomy.Results:From November 2024 to December 2024, three patients with gastric cancer underwent laparoscopic total gastrectomy with D2 lymphadenectomy and successfully accepted laparoscopic esophagojejunostomy based on the purse-string suture device with multi-functional seal cap. The operation time was 180 minutes, 260 minutes and 240 minutes, respectively with the time of anvil pacement of 4 minutes,4 minutes, 4.5 minutes for the three cases. The bleeding volume of each was 100 ml respectively. The proximal esophageal margins were 2 cm from the tumor, and the margins were negative for tumor. No extravasation of contrast agent was seen in the postoperative oral contrast anastomosis. All three patients were followed up for 33, 30, and 25 days after the operation, and no anastomotic bleeding, leakage, or other related complications were found.Conclusion:The circular anastomosis using purse-string suture device with multi-functional seal cap in totally laparoscopic total gastrectomy esophagojejunostomy is safe and feasible, which is a promising novel choice for laparoscopic radical treatment of gastric cancer with total gastrectomy oesophagojejunostomy.

Objective To investigate the influence of Let-7f regulation on MMP-11 in migration and in-vasion of pancreatic cancer. Methods RT-qPCR was performed to assay the expression of Let7 and MMP-11 ex-pression in pancreatic cancer cells and normal pancreatic cells. Let-7f mimic and inhibitor were transfected to PANC-1 and Bx-PC3, respectively. The influence of Let-7f expression on migration and invasion of pancreatic cancer cells was analyzed by transwell. The influence of Let-7f intervention on MMP-11 expression was observed by RT-qPCR. Results Let-7f expression decreased in PANC-1 and Bx-PC3, compared to HPDE6c7, while MMP-11 expression up-regulated in PANC-1 and Bx-PC3 , compared to HPDE6c7 cells. Let-7f overexpression in-hibited the expression of MMP-11. Up-regulated Let-7f could significantly inhibit migration and invasion of PANC-1 and Bx-PC3 and Let-7f inhibitor enhanced MMP-11 expression. However , down-expression of Let-7f could not significantly promote migration and invasion abilities of PANC-1 and Bx-PC3cells. Conclusions Let-7f may affect migration and invasion by regulating MMP-11 expression in pancreatic cancer , suggesting that Let-7f might be a potential target for gene therapy in human pancreatic cancer.