The effect of rosmarinic acid on 1,2-dimethylhydrazine induced colon carcinogenesis

Background: Anastomotic leak rates following colorectal anastomosis range from 4 to 26%, and the development of a leak is known to be correlated with worse prognosis after a curative resection for colorectal cancer. In addition, anastomotic leakage has been associated with increased mortality and risk of permanent stoma. While techniques to improve the leakage rates in colorectal surgery have been described, these have largely been through isolated case series. We sought to undertake an evidence-based approach to reviewing the use of such techniques. 

Methods: A systematic review of the literature was performed, evaluating the current evidence for techniques to improve leakage following colorectal anastomosis. 

Results: There is Level I evidence to support the use of intra-operative leak testing, defunctioning ileostomy and drain tube insertion in the correct settings, including those associated with poor patient, disease and/or operative factors. There is no clear evidence to support the use of handsewn techniques, stapling techniques or laparoscopy over other techniques. 

Conclusion: Reductions in morbidity and mortality from colorectal anastomotic leaks can be gained by performing intraoperative leak testing, defunctioning ileostomy and drain tube insertion in the correct settings. The technique for performing the anastomosis remains at the discretion of the surgeon and largely depends on experience, patient characteristics and the operative setting, rather than there being any clear evidence for one technique over another. New techniques and devices that overcome drawbacks in current practice are consistently being developed and tested, making further risk reduction in colorectal anastomosis of great future promise.

Reducing Anastomotic Leakage in Oncologic Colorectal Surgery: An Evidence-Based Review

Role of hesperetin (a natural flavonoid) and its analogue on apoptosis in HT-29 human colon adenocarcinoma cell line – A comparative study

Colon cancer is still one of the leading causes of death in USA and is increasing at an alarming rate in Asia. It is one of the major causes of death in industrialized countries, and its etiology is known to be a combination of hereditary, environmental, dietary factors and lack of physical activity. Chemoprevention plays a potential role in colorectal cancer. The present study was performed to evaluate the efficacy of hesperetin supplementation on colonic aberrant crypt foci, lipid peroxidation and antioxidant defense system in 1,2-dimethylhydrazine (DMH) induced colon carcinogenesis in male Wistar rats. The rats were segregated into six groups viz., group 1, control rats received modified pellet diet; group 2 rats received modified pellet diet along with hesperetin (30 mg/kg body weight/day); groups 3-6 administrated DMH (20 mg/kg body weight) subcutaneous injection once a week for the first 4 weeks; in addition groups 4-6 received hesperetin at three different doses of 10, 20 and 30 mg/kg body weight/day for 16 weeks. All the rats were sacrificed at the end of the experimental period of 16 weeks. Increased tumor incidence and increased number aberrant crypt foci (ACF) accompanied by a decrease in the tissue lipid peroxidation, glutathione S-transferase (GST), glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) activities were observed in DMH-treated rats. Administration of hesperetin to DMH treated rats significantly decreased the tumor incidence, the number of aberrant crypt foci with simultaneous enhancement of tissue lipid peroxidation, GST, GPx, SOD, and CAT activities. The results of this study suggest that hesperetin at a dose of 20 mg/kg body weight showed a significant beneficial effect against chemically induced colonic carcinogenesis in rats as compared to the other two doses.

Hesperetin exerts dose dependent chemopreventive effect against 1,2-dimethyl hydrazine induced rat colon carcinogenesis

Zingerone [4-(4-hydroxy-3-methoxyphenyl)-2-butane], one of the active phenolic components isolated from Zingiber officinale, has antioxidant and anticarcinogenic properties. In our study, we have evaluated the effect of different doses of zingerone on lipid peroxidation (thiobarbituric acid-reactive

Chemopreventive effect of zingerone against colon carcinogenesis induced by 1,2-dimethylhydrazine in rats.

Background
The introduction of circular staplers into colorectal surgery has revolutionized anastomotic techniques stretching the limits of sphincter preservation. Data on the double-stapling technique (DST) has been widely published in the West where the incidence of colorectal cancer is high. However studies using this technique and their results, in the Indian scenario, as well as the rest of Asia, have been few and far between.

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Stephen D Waterford

Papers

Outcomes of resection for rectal cancer in India: the impact of the double stapling technique.