LIM and SH3 protein 1 (LASP1) is a metastasis-related protein reported to enhance tumor progression in colorectal cancer (CRC). However, the underlying mechanism is still elusive. The chaperonin protein containing TCP1 (CCT) is a cellular molecular chaperone complex, which is necessary for the correct folding of many proteins. It contains eight subunits, CCT1-8. CCT8 is overexpressed in many cancers, however, studies on CCT8 are limited and its role on CRC development and progression remains elusive. In this study, we confirmed that CCT8 and LASP1 can interact with each other and express positively in CRC cells. CCT8 could recover the ability of LASP1 to promote the invasion of CRC; CCT8 could significantly promote the proliferation, invasion, and metastasis of colorectal cells in vivo and in vitro. Mechanically, CCT8 inhibited the entry of WTp53 into the nucleus, and there was a negative correlation between the expression of CCT8 and the nuclear expression of WTp53 in clinical colorectal tissues. CCT8 promoted the cell cycle evolution and EMT progression of CRC by inhibiting the entry of WTp53 into the nucleus. Clinically, CCT8 was highly expressed in CRC. More importantly, the overall survival of CRC patients with high expression of CCT8 was worse than that of patients with low expression of CCT8. These findings indicate that as LASP1-modulated proteins, CCT8 plays a key role in promoting the progression of colorectal cancer, which provides a potential target for clinical intervention in patients with colorectal cancer.

Background: In sphincter-preserving surgery for low rectal cancer, it is significant to reduce the number of stapler cartridges and the incidence of anastomotic leakage. On this basis, we have developed a safer and more economical technique— pushing the anus in laparoscopic radical resection of low rectal cancer.Method: From January 2015 to July 2020, 213 consecutive patients with rectal cancer received laparoscopic radical surgery. For 151 of these patients, the surgeon used the stapler cartridges (Ethicon Intraluminal Linear Staplers EC60A, Ethicon, USA) to transect the edge of tumor of the rectum (Conventional Surgery Group). And for another 62 patients, besides applying the stapler cartridges, the surgeon had the assistants push the anus forward from the perineum during the process of transecting the rectum (Pushing the Anus Group). The postoperative outcomes and complications were compared between the two groups.Results: In terms of the number of the stapler cartridges, the Pushing the Anus Group was less than the Conventional Surgery Group (P<0.001). Moreover, the incidence of anastomotic leakage in the Pushing the Anus Group is lower than that in the Conventional Surgery Group (P=0.043). Conclusions: With pushing the anus forward during the process of transecting the rectum, the sphincter-preserving surgery can be performed more safely and economically.

Background: For laparoscopic gastrectomy, it is significant to reduce the incidence of anastomotic leakage. The authors develop a novel technique for safe extracorporeal anastomosis that employs the bronchus forceps to reinforce the esophageal ring. Methods: From January 2017 to July 2020, 173 consecutive patients with gastric cancer received laparoscopic total gastrectomy or laparoscopic proximal gastrectomy. One hundred thirty-one patients only underwent extracorporeal anastomosis with a purse-string suture instrument (PSI) and a 25 mm circular stapler (Ethicon Intraluminal Circular Staplers CDH25A, Ethicon) (Conventional Surgery Group). In addition to these tools for extracorporeal anastomosis, the surgeon creatively used bronchus forceps to reinforce the esophageal ring on the anvil of circular stapler in 42 patients (Bronchus Forceps Ligation Group). The condition and the mean diameter of the narrowest part of the esophageal rings, postoperative outcomes, and complications were compared between the two groups. Results: Under direct vision, the esophageal rings were more complete in the Bronchus Forceps Ligation Group. Furthermore, the mean diameter of the narrowest part of the esophageal rings in the Bronchus Forceps Ligation Group was wider than that in the Conventional Surgery Group (4.34 -0.84 versus 2.68 -0.74 mm; P < .001). Meanwhile, the incidence of anastomotic leakage was lower in the Bronchus Forceps Ligation Group. Although reinforcing the anvil with the bronchus forceps will add additional surgery time, almost all can be done in less than 5 minutes. Conclusions: With applying the bronchus forceps to reinforce the esophageal ring on the anvil of the circular stapler, the extracorporeal anastomosis can be performed more safely.

Background Gastroduodenal anastomotic leakage is one of the most dreadful complications of gastrectomy and poses a great threat for treatment. However, there has been no effective treatment for it up to now. We report a case, a patient with huge gastroduodenal anastomotic leakage, was eventually recovered after conservative treatment up front and later resolution of anastomotic obstruction through gastrojejunostomy and jejunostomy. Case presentation: A 50-year-old man underwent a distal gastrectomy for a giant penetrating ulcer in the lesser curvature of the gastric sinus. Digestive reconstruction was completed by the Billroth I method. But an anastomotic leakage occurred on postoperative day 9 and a high output of duodenal juice was observed, and the following gastroscopy suggested that there was a large breach in the gastroduodenal anastomosis. Because of the patency of the drainage tube and the limitations of the patient's condition, conservative treatment was advocated and a nasojejunal tube was placed under the gastroscope for enteral nutrition. Unexpectedly, during subsequent treatment, persistent hypothermia associated with rheumatoid arthritis, drainage-associated transverse colon leakage and anastomotic stenosis occurred. Eventually, after taking the gastrojejunostomy and jejunostomy and gradually withdrawing and flushing the drainage tube, the patient was able to achieve a tube-free state and eat in the normal way. Conclusions The course of the patient’s treatment was continuous and systematic. In this case, we found that conservative treatment was feasible for giant gastroduodenal anastomotic leakage in the presence of patent drainage and limited physical signs. And for secondary anastomotic stenosis, gastrojejunostomy can effectively relieve the obstruction.