When compared to OA, laparoscopic appendectomy is advantageous in CA with regard to SSIs, with no significant additional risk of IAA (level 3a evidence).

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Purpose: To study the production of chemokines by colorectal hepatic metastases.Experimental Design: Biopsies of resected colorectal hepatic metastases and nonneoplastic adjacent liver tissue were screened for chemokines using protein arrays and results were confirmed by ELISA and immunohistochemistry. Results: Two chemokines, eotaxin-2 and MCP-1, were found at elevated levels within the tumor biopsy compared with adjacent liver. The relative increase in expression from tumor was much higher for eotaxin-2 than MCP-1, with 10 of 25 donors having a >100-fold increase in expression compared with 0 of 24 donors for MCP-1. In a parallel analysis, eotaxin-2 was also found at elevated levels in the tumor region of primary colorectal cancer biopsies. Immunohistochemical staining indicated that carcinoembryonic antigen^positive tumor cells stained strongly for eotaxin-2, implicating these cells as the predominant source of the chemokine. In vitro studies confirmed that several colorectal tumor lines produce eotaxin-2 and that secretion of this chemokine could be depressed by IFN-g and enhanced by the Th2-type cytokines interleukin-4 and interleukin-13. Jurkat T cells were engineered to express the receptor for eotaxin-2 (CCR3). These cells effectively migrated in response to eotaxin-2 protein, suggesting that immune cells gene modified to express a chemokine receptor may have improved abilities to home to tumor. Conclusions: Taken together, these observations confirm eotaxin-2 as a chemokine strongly associated with primary and metastatic tumors of colorectal origin. Furthermore, the importance of this result may be a useful tool in the development of targeted therapeutic approaches to colorectal tumors.Chemokines are small molecules that mediate the migration of lymphocytes and other immune cells around the body through binding of appropriate G protein -coupled receptors (1). To date, at least 50 human chemokines and 18 chemokine receptors have been described and it is the complex interplay and degeneracy of these receptors and ligands that form a network thought to control cellular migration patterns. It is becoming increasingly clear that the chemokine network plays an important role in cancer through its effect on the growth and metastasis of tumor cells as well as in manipulating host-tumor interactions (2). Examples include the chemokine receptor CXCR4, which has been identified on at least 23 different tumor cell types and has also been shown to play an important role in the migration of metastatic tumor cells in vitro (3 -6). In colorectal cancer, strong CXCR4 expression is significantly associated with increased stage, lymph node metastasis, and reduced 3-year survival (7,8). Furthermore, chemokines can also drive tumor cell proliferation as observed in glioblastoma cells, which expressed high levels of CXCR4 (9).Colorectal cancer is the third most common cancer in the United States with 50% to 60% of patients progressing to develop hepatic metastases (10). Despite this prevalence of clinical cases, rel...

Stapled transanal rectal resection can be performed on a day-case basis with high levels of patient satisfaction. Incontinence and constipation are improved. However, significant morbidity occurs in 7% of patients, and urgency of defecation persists beyond six months in 11%.

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