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The aim of this study was to evaluate the influence of laparoscopic rectal cancer surgery on circumferential resection margin (CRM) involvement.

Background:Phosphatase and tensin homolog (PTEN)is one of the most frequently mutated suppressor genes in human cancers. However, there are no data about the role of PTENIVS4 polymorphism in development of colorectal cancer (CRC). The authors aimed to determine the role of PTENIVS4 variants in the etiology of CRC.Patients and methods:A hospital-based case–control study was conducted in 203 patients with CRC (127 colon, 76 rectum) and 245 healthy controls. The frequencies of PTENIVS4 (rs 3830675) genotypes were determined by using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay.Results:The (-/-) genotype of PTENIVS4 that absence of ATCTT insertion at downstream of exon 4 in intron 4 of PTENgene was found to be associated with 1.55-fold increased risk of colon cancer (p < 0.005; OR: 1.55, 95% CI: 1.24 – 1.94) and 1.4-fold increased risk of rectum cancer (p < 0.005; OR: 1.4, 95% CI: 1.08 – 1.82). Subgroup analyses showed that PTENIVS4 genotypes were not associated with any clinicopathological characteristics of patients with CRC (p > 0.05).Conclusion:The (-/-) genotype of PTENIVS4 gene might be associated with increased risk for development of CRC in a Turkish population. Further studies will clarify the exact role of PTENIVS4 polymorphism in the etiology of CRC.

To compare the surgical outcomes of stapled and handsewn closures in loop ileostomies.

The purpose of the study was to assess the effects of the surgeon's learning curve on the short-term outcome of laparoscopic resections performed for rectal cancer.

Abstract: Purpose. This study was conducted to investigate the effect of octreotide on colorectal carcinogenesis by administering octreotide either alone or combined with polyglactin, which is a well-known suture material, on chemically induced colorectal cancer development in rats. Methods. A total of 72 rats were divided into six groups. Two groups were subjected to a colotomy and repair using polyglactin. Another two groups underwent a sham procedure. The fifth group received octreotide alone and the sixth group served as a control. Both groups of rats in the polyglactin and sham groups received octreotide additionally. Methylnitrosourea was administered rectally to all the animals at a dose of 4 mg/kg per week for 20 weeks to induce carcinogenesis. Octreotide was injected twice a day at a total daily dose of 100 μg/kg. The thymidine labeling index was used to assess the synthesis phase fraction in order to measure the cell proliferation rate. Results. The mean number of tumors per rat was significantly higher in the polyglactin group than in both the sham and control groups. It was significantly lower in the octreotide and polyglactin + octreotide groups than in the control and polyglactin groups, respectively. All the animals in the octreotide group had one tumor, while 66.6% of the control group had multiple tumors. The number of multiple tumors was significantly lower in the polyglactin + octreotide and sham + octreotide groups than in the polyglactin and sham groups, respectively. The mean tumor size in the octreotide group was significantly smaller than in the control group, whereas it was larger in the polyglactin group in comparison with the sham and control groups. It was also reduced in the polyglactin + octreotide group in comparison with the polyglactin group. The thymidine labeling index was significantly higher in the polyglactin group compared with both the sham and control groups, whereas it was lower in the octreotide group in comparison with the control group. The addition of octreotide administration to the polyglactin usage and the sham procedure significantly decreased the thymidine labeling indexes. Conclusion. These results indicate that octreotide reduces the frequency of tumor occurrence and has an inhibitory effect on its development in chemically induced experimental colorectal cancer. Octreotide can also reduce the enhancing effect of polyglactin on colorectal carcinogenesis when it is combined with polyglactin.

Abstract: Local tumor recurrence following restorative surgery for colorectal cancer may occasionally result from the promotion of a neoplastic lesion in a zone of proliferative instability adjacent to the anastomosis. This study was designed to determine the influence of various suture materials on experimental colorectal carcinogenesis. A total of 72 rats were divided into six groups, four of which were subjected to colotomy and repair using catgut, silk, polyglactin (PG), or stainless steel. The fifth group was given a sham procedure and the sixth group served as a control. Methylnitrosourea was administered rectally to all the animals, at a dose of 4 mg/kg/week for 20 weeks. The mean number of tumors per rat was significantly higher in the PG group than in the other groups. The mean tumor size was found to be significantly larger in each of the suture material groups than in the sham group. A tendency for tumor occurrence to develop at the anastomosis rather than at the other colon sites was seen in the PG group. These results indicate that PG has an adverse effect on local tumor occurrence in experimental colorectal carcinogenesis.

PURPOSE: Octreotide is an analog of somatostatin, with the same biologic effects but a longer half-life than somatostatin. The purpose of this experimental study was to search the effects of octreotide on the healing of bowel anastomosis and to observe the anatomic and physiologic changes in the obstructed bowel. METHODS: Two groups of ten male Wistar albino rats (average weight, 250 grams) were used in this study. One group was the octreotide group, and the other was the control group. In both groups, the basal diameters of jejunum were measured before ligation of the bowel 20 cm from the duodenum. Octreotide was administered subcutaneously (7 μg/kg/day, in two equal doses) in the first group, and the same volume of saline was used in the control group. Diameters of the obstructed segments were measured, and sodium and potassium levels, obtained from the luminal fluid of the obstructed bowel, were recorded 48 hours following the first operation. Dilated segments were resected, and end-to-end intestinal anastomoses were performed. In rats sacrificed on the fourth and seventh days following the second operation, bursting pressures of the anastomotic and hydroxyproline levels in tissue samples taken from the anastomosis were measured. RESULTS: The diameter of the obstructed bowel increased significantly in the control group (P<0.05). Sodium and potassium losses were significantly less in the octreotide group (P<0.001 for sodium;P<0.01 for potassium). In histopathologic examination, ischemic changes were more evident in the control group (P<0.05). Anastomotic bursting pressure differences were not significant on the fourth postoperative day (P>0.05), but differences were significant on the seventh postoperative day (P<0.05). Anastomotic tissue hydroxproline synthesis on the fourth and seventh postoperative days of the octreotide and control groups did not show significant difference (P>0.05). CONCLUSION: In this experimental model, it appears that octreotide attenuates the ischemic changes and electrolyte losses in the obstructed bowel.