Objective: To investigate the feasibility, safety and short-term clinical efficacy of early hyperthermic intraperitoneal chemotherapy (HIPEC) after radical resection of T4 colorectal cancer. Methods: The clinical data of 96 patients with T4 colorectal cancer treated from January 2011 to June 2013 were retrospectively analyzed. Of the patients, 48 cases began to receive HIPEC from postoperative day 5 or 6 (once daily for a total of 3 sessions), and then underwent the first systemic infusion of mFOLFOX6 regimen within postoperative one month, for a total of 6 cycles (HIPEC group), and another 48 cases only underwent systemic chemotherapy of the same regimen (control group). The incidence of adverse effects and complications, and the 1- and 2-year recurrence and survival rate as well as the quality of life of the two groups of patients were compared. Results: HIPEC and systemic chemotherapy were all successfully performed. There were no surgical deaths or complications such as incisional wound infection, anastomotic leakage and adhesion intestinal obstruction in either group. There were no significant differences in incidence of myelosuppression, nausea, vomiting and liver dysfunction between the two groups (all P>0.05). The 1- and 2-year recurrence rate in HIPEC group were significantly lower than those in control group (2.1% vs. 20.8%; 6.3% vs. 31.3%, P<0.05). There was no difference in 1-year survival rate between the two groups (P>0.05), but the 2-year survival rate was significantly higher in HIPEC group than that in control group (81.3% vs. 58.3%, P<0.05). The ratio of patients with increased score of quality of life in HIPEC group was significantly higher than that in control group (75.0% vs. 25.0%, P<0.05). In HIPEC group, the median survival time of patients with colon cancer was significantly longer than that of patients with rectal cancer (32 months vs. 18 months, P<0.05). Conclusion: Early postoperative HIPEC for T4 colorectal cancer following radical resection is safe and feasible. It can effectively reduce peritoneal recurrence and metastasis, improve the short-term survival and quality of life of the patients, and has no obvious adverse effects.

Objective: To assess the clinical value of X-ray-assisted endoscopic stent placement and laparoscopic resection in treatment of obstructive colorectal cancer. Methods: Seventy-five eligible patients with cancer in the descending colon or rectum presenting with obstruction during January 2007 to December 2013 were selected. Of the patients, 37 cases underwent X-ray- assisted endoscopic stent placement and laparoscopic resection (combination group), and 38 cases were subjected to open resection plus intraoperative colonic lavage (conventional group). The main clinical variables between the two groups were compared. Results: The preoperative data between the two groups of patients were comparable. In combination group, the success rate of stent placement via colonoscopic procedure was 89.19% (33/37) and success rate of laparoscopic operation was 3.94% (31/33), and the 6 cases with operative failure were excluded. Compared with conventional group, except for increased cost of treatment (30 600 yuan vs. 25 500 yuan), the combination group showed significant advantages in intraoperative polyp detection rate (35.48% vs. 7.89%), radical resection rate (83.9% vs. 71.1%), rate of intraoperative preventive terminal ileostomy (6.45% vs. 23.68%), operative time (175.45 min vs. 202.24 min), length of incision (4.88 cm vs. 16.84 cm), number of resected lymph nodes (16.80 vs. 11.92), incidence of overall complications and infection-related complications (16.13% vs. 39.47%; 6.45% vs. 26.32%), length of postoperative hospital stay (7.36 d vs. 11.05 d), rate of second-stage surgery (6.5% vs. 28.9%), and positive rate of polyps at 3 months postoperatively (all P<0.05). There was no statistical difference in 1-, 3- and 5-year survival rate between the two groups (all P>0.05). Conclusion: X-ray-assisted colonoscopy combined with laparoscopic resection for obstructive colorectal cancer is safe and feasible, and it also has ideal radical effects and can reduce the rate of second-stage surgery.

Objective: To evaluate the clinical safety and efficacy of Ti-Ni alloy stent placement through colonoscopy combined with X-ray assistance for advanced colorectal cancer with acute bowel obstruction. Methods: Thirty-five patients with advanced colorectal cancer and acute bowel obstruction underwent palliative treatment by permanent stent placement (stent group), and 35 patients with the same conditions who were subjected to traditional colostomy served as control group. The success rate of operation and clinical effects of the two groups of patients were compared. Results: In stent group, success rate of stent placement was 100%, incidence of postoperative complications was 8.57% (postoperative intestinal perforation in one case and stent obstruction in two cases), patients began ambulation immediately after operation, without creating an artificial anus, and the survival rate was 94.2 % during 1-year followed-up. In control group, the surgical success rate was 100%, incidence of postoperative complications was 31.42% (postoperative pulmonary infection in 5 cases, wound infection in 5 cases, and abdominal infection in 1 case), and the survival rate was 97.1% during 1-year followed-up. The intestinal obstruction was completely resolved in patients of either group after operation, but in stent group compared with control group, the intestinal obstruction was quickly relieved, quality of life was improved, expense was reduced and incidence of complications was decreased and all differences had statistical significance (all P<0.05). Conclusion: Ti-Ni alloy stent placement by colonoscopy combined with X-ray assistance is a safe and effective palliative treatment for advanced colorectal cancer with acute bowel obstruction, with the advantages for patients having less suffering and better quality of life, and it also confers to patients a similar survival time as surgical treatment.

Objective: To assess the safety and efficacy of performing laparoscopic-assisted radical gastrectomy in patients with a history of prior abdominal surgery. Methods: The literature of studies comparing laparoscopy-assisted gastrectomy for patients with and without previous abdominal surgery was searched in several databases since their inception. After literature screening based on the inclusion criteria and exclusion criteria, data extraction and quality assessment, Meta-analysis was performed by Revman 5.3 software. Results: Five articles with 6 studies were finally included, involving a total of 982 patients, of whom 286 cases had a history of abdominal surgery and 696 cases did not. Results of this Meta-analysis indicated that in patients with previous history of abdominal surgery compared with those without history of abdominal surgery, the operative time was prolonged (WMD=15.51, 95% CI=12.74–18.28, P<0.05), but all other variables that included intraoperative blood loss (WMD=–0.36, 95% CI=–9.65–8.92), status of intraoperative lymph node dissection (WMD=1.78, 95% CI=–2.36–5.92), length of hospitalization (WMD=0.65, 95% CI=–0.33–1.62), and incidence of postoperative complications (OR=1.63, 95% CI=0.97–2.75) had no statistical difference (all P>0.05). Conclusion: History of abdominal surgery exerts no significant influence on performing laparoscopic-assisted gastrectomy, so this procedure is safe and feasible.

Colorectal cancer (CRC) results from multistep and multifactorial processes and is associated with the influences of multiple genes. Recent studies demonstrated that microRNAs (miRNAs) have close relation with the regulation of gene expressions in oncogenesis of CRC. MiRNAs can regulate proteins through their target genes, and these proteins controlled by miRNAs can also in turn modulate the expression of miRNAs, which establishes a complex regulatory network that plays an important role in occurrence and development of tumors. MiR-101 has been found down-regulated in CRC, and regulating the proliferation, invasion and metastasis of CRC cells through multiple target sites and pathways. In this article, the authors address the role of miR-101 in formation and progress of CRC.