ObjectiveTo summarize the progress in mutant gene sequences of different types of hereditary colorectal cancer.MethodThe relevant literatures about genetic mutations in hereditary colorectal cancer at home and abroad were reviewed.ResultsHereditary colorectal cancer coule be divided into two categories according to whether it was related to the germline mutations of known oncogenes. Among the known germline mutant genes, the gene of adenomatous polyposis coli (APC), MUTYH, thymidine glycol DNA glycosylase 1 (NTHL1), polymerase (DNA) epsilon, catalytic subunit (POLE), and polymerase (DNA) delta 1, catalytic subunit (POLD1) were closely related to adenomatous polyposis syndromes, mismatch repair (MMR)-related genes were related to Lynch syndrome, serine/threonine kinase 11 (STK-11) gene was related to Peutz-Jeghers syndrome, mutant genes of SMAD4 and bone morphogenetic protein receptor type 1A (BMPR1A) were found in JPS individuals, and Cowden syndrome was caused by phosphatase and tensin homology deleted on chromosome ten (PTEN) gene mutation. For colorectal cancer patients with unknown germline mutations but significant genetic characteristics (such as hyperplastic polyposis), relevant genes had also been gradually searched out, which needed further evidence.ConclusionsColorectal cancer is a malignant tumor with genetic characteristics. Compared with sporadic colorectal cancer, the time of hereditary colorectal cancer from adenoma to cancer is shorter, and the occurrence of heterogeneous tumor is also increased, but the survival rate after active intervention is higher than the sporadic one. To study the mutant gene sequences of hereditary colorectal cancer is the improvement and development of the diseases control in modern medicine.
ObjectiveTo investigate the application value of bidirectional sutured esophagojejunal Overlap anastomosis in totally laparoscopic total gastrectomy (TLTG). MethodsA retrospective analysis was performed on 128 patients with gastric cancer who underwent TLTG in the Department of General Surgery, The Third People’s Hospital of Chengdu/Clinical College of Southwest Jiaotong University·The Affiliated Hospital of Southwest Jiaotong University from December 2020 to December 2023. Patients in the observation group underwent bidirectional sutured esophagojejunal Overlap anastomosis, while patients in the control group received conventional Overlap side-to-side esophagojejunostomy. The two groups were then compared based on clinical outcome measures. ResultsA total of 128 patients were included, including 80 in the observation group and 48 in the control group. The intraoperative anastomosis time [(25.75±5.78) min vs (29.43±2.73) min, P＜0.001], operative time [(244.81±39.16) min vs (257.18±44.36) min, P=0.037], time to postoperative flatus [(2.30±0.80) d vs (2.85±1.33) d, P=0.004], and postoperative hospital stay [(7.15±2.10) d vs (9.00±2.66) d, P＜0.001] of the observation group were shorter than those in the control group. In the observation group, anastomotic leakage occurred in one patient (Clavien-Dindo grade Ⅱ), who improved with conservative treatment and was discharged. All patients were successfully followed up after surgery, and the median follow-up time was 12 months. During follow-up, four deaths occurred (two in the observation group and two in the control group), all non-cancer-related. No other complications, recurrences, or metastases were observed. ConclusionBidirectional sutured esophagojejunal Overlap anastomosis is safe and feasible in TLTG, providing favorable short-term effects.
