The Role of Tumor-associated Macrophages in Colorectal Peritoneal Metastasis in Mice.

Introduction: In the tumor microenvironment, macrophages function as M1 macrophages, which cause cytotoxicity to tumor cells in the early stages, and M2 macrophages, which contribute to the proliferation of cancer cells in the late stages. This study aimed to examine the mechanism of action of macrophages in ascites using a peritoneal dissemination mouse model of colorectal cancer.

Materials And Methods: Mouse models of peritoneal dissemination were created by injecting murine colorectal cancer cells into the abdominal cavity of non-obese diabetic/severely combined immunodeficient mice.

Late anastomotic complication after laparoscopic surgery for clinical stage I low rectal cancers located within 5 cm of the anal verge: Sub-analysis of the ultimate trial.

Background: Although extensive research has been conducted on early anastomotic leakage (AL) after sphincter-sparing surgery, the status of late anastomotic complications (post-30 days) has received limited attention. These late complications significantly affect a patient's quality of life and often lead to permanent stoma creation.

Methods: This study conducted a sub-analysis of a phase II trial assessing the outcomes of laparoscopic surgery for cStage I lower rectal adenocarcinoma (the ultimate trial).

A multicentre prospective study of anal function after laparoscopic ultra-low rectal cancer surgery using a mixed-effects model.

Aim: Abdominoperineal resection with permanent colostomy has historically been performed for very low rectal cancer located near the anal canal. Anus-preserving surgeries, such as intersphincteric resection (ISR) and low anterior resection (LAR), have recently become more common. However, postoperative anal function is a concern in these surgeries when the anastomosis is very low.

Experience with Laparoscopic Surgery for Rectal Obstruction Caused by Intestinal Endometriosis with a Frozen Pelvis: A Case Report.

Introduction: While intestinal obstruction is common, intestinal endometriosis is relatively rare, making its etiology still poorly understood. We report a case of rectal obstruction caused by intestinal endometriosis with a frozen pelvis, treated with laparoscopy in collaboration with gynecologists.

Case Presentation: A 39-year-old female patient was diagnosed with rectal obstruction resulting from endometriosis with a frozen pelvis by her previous physician and subsequently treated with a transverse colon stoma for rectal obstruction and hormonal therapy for endometriosis.

[A Case of Rectal Cancer with Lateral Lymph Node, Liver and Lung Metastases after Surgery, Successfully Undergoing Radical Resection with Multidisciplinary Treatment].

The patient is a 50s-year-old man. He had a past history of familial adenomatous polyposis(FAP)and was diagnosed with hereditary multiple colorectal cancer(RS, Rb). Therefore, he underwent total colectomy with ileostomy.

GLP- 1R status using validated monoclonal antibody in 689 cases of neuroendocrine neoplasm and its correlation with somatostatin receptor scintigraphy, insulin production, and histological grades.

Radiolabeled glucagon-like peptide 1 (GLP- 1) analog scintigraphy is a new, high-sensitivity imaging method for detecting small insulinomas. Somatostatin receptor scintigraphy (SRS) is an established method for detecting gastroenteropancreatic neuroendocrine tumors. However, small benign insulinomas are difficult to detect using SRS.

Longitudinal follow-up of sexual function after surgery for ultra-low rectal cancers located within 5 cm of the anal verge: A multicentre collaborative study.

Aim: The effect of laparoscopic surgery on sexual function in patients with ultra-low rectal cancer remains unexplored. This multicentre study evaluated postoperative sexual function in male patients with rectal cancer located within 5 cm of the anal verge.

Method: A total of 139 male patients aged ≤70 years with clinical T1-2N0M0 rectal cancer underwent laparoscopic surgery between January 2014 and March 2017 at 47 institutions.

Circulating Tumor DNA Methylation Is a Biomarker of Poor Recurrence-free Survival in Locally-Advanced Rectal Cancer.

Background/aim: The aim of this study was to investigate locus-specific circulating-tumor DNA (ctDNA) methylation for predicting long-term outcomes of locally-advanced rectal cancer (LARC) after resection.

Materials And Methods: In the present study, there were 50 patients without preoperative treatment and 35 patients with preoperative treatment. Methylation analyses for checkpoint with forkhead and ring finger domains (), sex-determining region Y-box transcription factor 11 () and cysteine dioxygenase type 1 () used DNA extracted from plasma ctDNA at the time of resection of the primary tumor with curative-intent surgery.

Upfront surgery, neoadjuvant chemoradiotherapy, or neoadjuvant chemotherapy for rectal cancer with lateral lymph node metastasis: A multicenter MRI and lateral lymph node dissection study.

Aim: The purpose was to clarify the oncological outcomes of rectal cancer (RC) with lateral lymph node metastasis (LLNM) on high-resolution MRI (HRMRI), considering preoperative treatments.

Methods: Two hundred and twelve patients, from 13 hospitals, diagnosed with RC with lateral lymph node dissection (LLND), between 2017 and 2019, were prospectively registered. LLNM was defined as a short-axis size ≥5 mm.

Impact of Low Ligation on Bowel Perfusion and Anastomotic Leakage in Minimally Invasive Rectal Cancer Surgery: A Post Hoc Analysis of a Randomized Controlled Trial.

Background: Whether the level of the inferior mesenteric artery ligation affects the incidence of anastomotic leakage remains unclear.

Objective: To assess the impact of the level of inferior mesenteric artery ligation on blood flow to the anastomotic site and the incidence of anastomotic leakage using indocyanine green fluorescence imaging.

Design: A post hoc analysis of the EssentiAL trial.

Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer.

Objectives: This study was conducted to investigate whether preoperative or postoperative carcinoembryonic antigen (CEA) with a new cut-off value is more optimal for predicting long-term outcomes in patients with Stage II/III rectal cancer, and to investigate the effectiveness of postoperative adjuvant chemotherapy (POAC) based on the CEA values.

Methods: Serum CEA levels were measured preoperatively (pre-CEA) and postoperatively (post-CEA). The area under the receiver operating curve (AUROC) was used to determine a cut-off for CEA.

Effects of Diverting Stoma Creation in Minimally Invasive Surgery for Rectal Cancer.

Objectives: In rectal cancer surgery, a diverting stoma (DS) is used to prevent severe anastomotic leakage (AL), peritonitis, reoperation, and longer hospitalization. DS creation has increased in the last few decades, without establishment of clear criteria for construction of a DS. Therefore, the goal of the study was to investigate the validity of DS construction based on risk factors for AL, as an approach to reduce the number of stoma creations.

Clinical Outcomes of Single-incision Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy in Adult Acute Appendicitis.

Objectives: Laparoscopic surgery is widely performed for acute appendicitis. We started conventional 3-port laparoscopic appendectomy (CLA) in 1995 and introduced single-incision laparoscopic appendectomy (SILA) in 2009. This study compared perioperative outcomes between SILA and CLA to evaluate the usefulness of SILA.

Postoperative urinary dysfunction following lateral lymph node dissection for rectal cancer via minimally invasive surgery.

Background: Lateral lymph node dissection (LLND) for locally advanced rectal cancer (LARC) is performed widely since it reduces local recurrence. However, there are some disadvantages to LLND, including technical difficulties and association with postoperative urinary dysfunction. Procedures for LARC have also become more minimally invasive: laparoscopic surgery (LS) has become more common, and use of robot-assisted LS (RALS) is increasing.

Three Surgical Cases of Cecal Volvulus.

Cecal volvulus (CV) is a relatively rare disease; however, it often requires emergency surgery due to the low success rate of endoscopic treatment, in contrast to sigmoid volvulus. The mechanism of CV involves a mobile cecum at the base, triggered by factors such as constipation, high-fiber diets, laxative use, history of laparotomy or laparoscopic surgery, pregnancy, and prior colonoscopy, which twists the ileocecal region. Although CV is a benign disease, it can be fatal if treatment is delayed, so it is crucial to understand the pathophysiology and treatment.

Ureteral cancer successfully treated with laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery for pelvic arteriovenous malformation.

Introduction: Pelvic arteriovenous malformation is often a source of intraoperative bleeding. Here, we report our experience with a case of ureteral cancer with pelvic arteriovenous malformation treated using laparoscopic nephroureterectomy with temporary intraoperative occlusion of the internal iliac artery.

Case Presentation: A 75-year-old man presented to our hospital with asymptomatic macro-hematuria.

Identification of lateral pelvic nodes without metastasis in patients with rectal cancer treated with preoperative chemoradiotherapy or chemotherapy based on magnetic resonance imaging.

Background: Intensive localized therapy is promising for the treatment of rectal cancer. In Japan, chemoradiotherapy (CRT) and neoadjuvant chemotherapy (NAC) are used as preoperative treatments for this disease. Magnetic resonance imaging (MRI) is used to diagnose lateral pelvic node (LPN) metastases, but the changes in LPN findings on MRI following preoperative treatment are unclear.

Prognostic utility of circulating tumor DNA methylation analysis in stage IV colorectal cancer.

Background And Objectives: Our aim in this study was to investigate the usefulness of circulating tumor (ct) DNA methylation analysis for predicting long-term outcomes after resection in Stage IV colorectal cancer (CRC).

Methods: Methylation analyses were performed on 95 plasma samples from patients with CRC who underwent surgery. The methylation status (relative methylation value: RMV) of CpG within the promoter region of three genes (CHFR, SOX11, and CDO1) was assessed to quantitative methylation-specific PCR (qMSP) analysis.

Feasibility of robotic-assisted surgery in advanced rectal cancer: a multicentre prospective phase II study (VITRUVIANO trial).

Background: The potential benefits of robotic-assisted compared with laparoscopic surgery for locally advanced cancer have not been sufficiently proven by prospective studies. One factor is speculated to be the lack of strict surgeon criteria. The aim of this study was to assess outcomes for robotic surgery in patients with locally advanced rectal cancer with strict surgeon experience criteria.

Use of 3D-CT-derived psoas major muscle volume in defining sarcopenia in colorectal cancer.

Background: Sarcopenia is characterized by reduced skeletal muscle volume and is a condition that is prevalent among elderly patients and associated with poor prognosis as a comorbidity in malignancies. Given the aging population over 80 years old in Japan, an understanding of malignancies, including colorectal cancer (CRC), complicated by sarcopenia is increasingly important. Therefore, the focus of this study is on a novel and practical diagnostic approach of assessment of psoas major muscle volume (PV) using 3-dimensional computed tomography (3D-CT) in diagnosis of sarcopenia in patients with CRC.

Short- and long-term outcomes of surgical treatment for inguinal lymph node metastasis in rectal and anal canal adenocarcinoma.

Aim: The significance of lymphadenectomy and its indications in patients with inguinal lymph node metastasis (ILNM) of anorectal adenocarcinoma is unclear. This study aimed to clarify the surgical outcomes and prognostic factors of inguinal lymphadenectomy for ILNM.

Method: This study included patients who underwent surgical resection for ILNM of rectal or anal canal adenocarcinoma with pathologically positive metastases between 1997 and 2011 at 20 participating centres in the Study Group for Inguinal Lymph Node Metastasis from Colorectal Cancer organized by the Japanese Society for Cancer of the Colon and Rectum.