Objective To study the effect of laparoscopic total mesorectal excision and per anum rectal pull-type of anastomosis on male patients with low rectal cancer. Methods The successful experiences of anus saving operation on 23 male patients with low rectal cancer were summarized. Results A laparoscopic total mesorectal excision technique was used, with the full separation of the rectum at the bottom. After pulling out the distal rectum together with the cancer from the anus, the transection of the proximal tumor was performed. The end-to-end anastomosis of rectum and descending colon was performed by tubular stapler. Anus was reserved successfully in the 23 cases. There was no left-tumor stump after surgery detected by postoperative pathological examinations, no anastomotic leakage, and no operative death. Conclusions To the relatively narrow male pelvis, laparoscopic total mesorectal excision and per anum rectal pull-through resection and anastomosis is safe and reliable for anus saving in low rectal cancer. It can simplify the operation, and raise the success rate of sphincter preserving in surgery of low rectal cancer.
Objective To investigate expressions of silence signal regulating factor-1 (SIRT-1) and epithelial cadherin (E-cadherin) in gastric cancer and their clinical significances. Methods The immunohistochemistry SP technique was used to detect the expressions of SIRT-1 and E-cadherin in the gastric cancer tissues and their corresponding paracancerous gastric tissues. The relationship between the SIRT-1 expression and E-cadherin expression was analyzed using Spearman. Results The positive rate of the SIRT-1 protein expression in the gastric cancer tissues was significantly higher than that of the corresponding paracancerous gastric tissues (χ2=5.791, P=0.016). The SIRT-1 protein positive expression was related to the Lauren histological type of gastric cancer (χ2=4.941, P=0.026), in other words, in the intestinal type was significantly higher than that of the diffuse type, but which was not related to the age, gender, tumor size, tumor site, differentiation degree, TNM stage, or lymph node metastasis (P>0.05). While the positive rate of the E-cadherin protein expression in the gastric cancer tissues was significantly lower than that of the corresponding paracancerous gastric tissues (χ2=10.868, P=0.001), which in the intestinal type of gastric cancer was significantly lower than that in the diffuse type of gastric cancer (χ2=5.203, P=0.023), also not related to the age, gender, tumor size, tumor site, differentiation degree, TNM stage, or lymph node metastasis (P>0.05). There was a negative correlation between the SIRT-1 protein and the E-cadherin protein (rs=–0.381, P=0.013). Conclusions Gastric cancer with higher SIRT-1 expression might be way to achieve tumor development through E-cadherin as a facilitator. Upregulation of SIRT-1 and declining of E-cadherin might play a possible role in intestinal type gastric cancer.