Predictive value of computed tomography with coronal reconstruction in right hemicolectomy with complete mesocolic excision for right colon cancers: a retrospective study

Frequencies and Injury Analysis of Small Anterior Branch of Gastrocolic Trunk

Objective: Small anterior branch of gastrocolic trunk (SABGT) can be occasionally observed during transverse colectomy and right hemicolectomy. Improperly dealing with the branch may lead to unwanted bleeding and affect the operation process. The purposes of this study are to analyze the frequencies and injury of SABGT. Methods: Intact operation data were collected retrospectively from 39 colon cancer patients who underwent curative laparoscopic transverse colectomy or right hemicolectomy. Frequencies and injury of SABGT were analyzed. Results: Eight cases had SABGT, the frequencies of which is 20.5%. Injury of SABGT occurred intraoperatively in 2 patients. Conclusion: We suggest that SABGT should be considered in surgical management. Consciously looking for and properly dealing with the branch can minimize the influence on the operation process.

Analysis of gastrointestinal function and prognostic value of tumor markers in patients with laparoscopic radical resection of colorectal cancer

OBJECTIVE

To analyze the gastrointestinal function and prognostic value of tumor markers (TMs) in patients with laparoscopic radical resection of colorectal cancer (LRRCC).

METHODS

The research population of this retrospective study comprised 141 patients with CC who received treatment in the Zhongshan Hospital of Xiamen University between July 2017 and August 2018, including 74 cases (observation group, OG) treated with LRRCC and 67 cases (control group, CG) undergoing open surgery (OS). Postoperative gastrointestinal function and complications were recorded. Besides, alterations in serum TMs carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), and the 3-years survival of patients were observed. Receiver operating characteristic (ROC) curves were used to determine the prognostic value of TMs. Risk factors affecting the prognosis of LRRCC patients were analyzed by the Cox regression model.

RESULTS

Significantly higher levels of motilin (MOT) and gastrin (GT) were determined in OG compared with CG. The two groups showed no notable difference in the postoperative complication rate. Postoperative serum CEA and CA199 levels were obviously lower in OG as compared with CG. A higher 3-year survival rate was determined in OG. The areas under the receiver operating characteristic (ROC) curve (AUCs) of CEA and CA19-9 levels in predicting patients' 3-year survival were 0.826 and 0.867, respectively. According to the Cox regression analysis, tumor diameter, lymph node involvement, TNM staging, vascular invasion, CEA, and CA19-9 were independent risk factors for poor prognosis of LRRCC patients.

CONCLUSIONS

LRRCC is well-tolerated by patients with CC and contributes to favorable outcomes. Besides, CEA and CA19-9, the two TMs, may be candidate prognostic markers for patients undergoing LRRCC.

Value of MSCT plus MRI in the Detection of Colon Cancer

Colon cancer is a common digestive system malignancy with nonspecific early symptoms, which necessitates better early detection methods. The present study was conducted to assess the accuracy and clinical value of multislice spiral CT (MSCT) plus magnetic resonance imaging (MRI) for colon cancer. Between January 2019 and July 2020, 100 patients with pathologically confirmed colon cancer treated in Wuxi People's Hospital were assessed for eligibility and recruited. All eligible patients received MRI and MSCT without any treatment prior to scanning. The accuracy of preoperative diagnosis and staging of colon cancer by MRI, MSCT, and MRI plus MSCT were analyzed using postoperative pathological results as the gold standard, and consistency analysis was performed. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was obtained to analyze the preoperative diagnostic value. The accuracy of MRI, MSCT, and MRI plus MSCT was 98.00%, 96.00%, and 100% with good consistency (Kappa = 0.732, 0.703, and 0.756). The AUC of MRI, MSCT, and MRI plus MSCT was 0.889, 0.861, and 0.903, respectively. The preoperative diagnostic accuracy of MRI for colon cancer at T1, T2, T3, and T4 stages was 76.92%, 82.61%, 73.47%, and 86.67%, respectively, those of MSCT was 53.85%, 69.57%, 63.27%, and 40.00%, respectively, and those of MRI plus MSCT was 100.00%, 95.65%, 95.92%, and 86.67%, respectively. Consistency analysis yielded good consistency for the diagnosis of the T-staging of colon cancer (Kappa = 0.754, 0.731, 0.776). MSCT plus MRI yielded higher accuracy, specificity, and sensitivity in the detection of colon cancer versus the standalone MRI or MSCT, which demonstrated great potential in the early detection of colon cancer with a high clinical value.