Gastroduodenal tuberculosis (GD-TB) is exceptionally rare. The clinical manifestations of gastrointestinal TB are diverse and non-specific, which makes diagnosis difficult, leading to delayed diagnosis and high mortality. As a peer-reviewer of World Journal of Clinical Cases, I would like to share my opinion on the article published by this journal. The patient had no family history of TB or contact with people with TB. Primary GD-TB presenting as gastric outlet obstruction and normal findings of thoracic computed tomography increased the difficulty of diagnosis and treatment in this patient. The diagnosis and treatment scheme of this typical case have reference value for the clinical treatment of GD-TB.

Colorectal cancer (CRC) is the third most common cancer worldwide and the second most common cause of cancer death. Nanotherapies are able to selectively target the delivery of cancer therapeutics, thus improving overall antitumor efficiency and reducing conventional chemotherapy side effects. Mesoporous silica nanoparticles (MSNs) have attracted the attention of many researchers due to their remarkable advantages and biosafety. We offer insights into the recent advances of MSNs in CRC treatment and their potential clinical application value.

Fecal incontinence is a common symptom among patients with rectal prolapse. Pudendal nerve terminal motor latency (PNTML) testing can serve as a reference indicator for predicting the outcomes of rectal prolapse surgery, thereby assisting surgeons in formulating more appropriate surgical plans. The direct correlation between preoperative PNTML testing results and postoperative fecal incontinence in patients with rectal prolapse remains a contentious issue, necessitating further clarification. Thus, we analyze the existing publications from both clinical and statistical perspectives to comprehensively evaluate the accuracy of preoperative PNTML testing in rectal prolapse and provide some feasible statistical solutions.

Abstract Background Early-stage rectal cancer is used in cases of histological findings including pTis and pT1 tumors, which are no metastases, no lymphovascular or perineural invasion, and located at the mucosa level of the intestinal wall. Low early-stage rectal cancer (LeREC), transanal resection can be an attractive alternative to less invasive surgical procedures and postoperative complications. However, none of the currently used surgical methods could be considered an ideal surgical option that is effective, safe, and painless. We hypothesized that a combination of the simplified transanal excision (sTE) and Ruiyun procedure for hemorrhoids (RPH) will increase the safety and effectiveness of surgical treatment low early-stage rectal cancer. Purpose To explore the safety and efficacy of the Transanal endoscopic microsurgery (TEM) or combining the sTE with RPH in the treatment of LeREC. Methods This is a randomized, controlled, balanced study of 48 patients with LeREC, who diagnosed with low early-stage rectal tumor less than 12 cm from the anal verge and were candidates for TEM or combining the sTE with RPH. Expression of CDK2, CDK4, CDK6, FOXD1 and PAK4 were determined in primary tumors from 48 patients with locally LeREC scheduled for TEM (20 cases) or RPH with the sTE (28 cases). The outcomes and postoperative complications were compared between 2 types of surgeries. Results Between Feb 1, 2015, and Dec 31, 2019, 48 patients were randomly assigned. 20 to TEM and 28 to combining sTE with RPH surgery. Then, all patients had been followed up within 12 months. Histopathological features for CDK2/4/6, FOXD1 and PAK4 proteins that would be considered to be associated with increased risk of tumor recurrence. Conclusions sTE combined with RPH can reduce the incidence of intraoperative bleeding, reduce the cost of surgery, facilitate diagnosis and treatment in grassroots hospitals, and improve the curative efficacy in the treatment of patients with lower two-thirds of early-stage rectal cancer.

Rectal foreign bodies (RFB) are quite uncommon except in very busy hospitals. Because of their rarity, it is seldom that the treating physicians have a standard approach to the diagnosis, technique of extraction, and post-extraction evaluation. This can be further complicated by the rather extreme variability of size, shape, and texture of the foreign bodies, as well as the potential extent of trauma to the rectum or distal colon. The objectives of this study were to delineate the demographics, classification of cause, and injury patterns of RFB and to present the results of the transanal surgical management of a large series of RFB. We retrospectively collected extensive data from the hospital medical records of the 291 patients who presented with RFB to the emergency department of Shenyang Proctological Hospital (Shenyang, China) from 2012 July to 2020 December. Specifically, demographics, origins and circumstance of the RFB, complications, injuries, anesthesia method, and the results of the transanal surgical management were recorded and analyzed. Of the 291 RFB cases, 225 (77.3

BACKGROUND The most common causes of outlet obstructive constipation (OOC) are rectocele and internal rectal prolapse. The surgical methods for OOC are diverse and difficult, and the postoperative complications and recurrence rate are high, which results in both physical and mental pain in patients. With the continuous deepening of the surgeon’s concept of minimally invasive surgery and continuous in-depth research on the mechanism of OOC, the treatment concepts and surgical methods are continuously improved. AIM To determine the efficacy of the TST36 stapler in the treatment of rectocele combined with internal rectal prolapse. METHODS From January 2017 to July 2019, 49 female patients with rectocele and internal rectal prolapse who met the inclusion criteria were selected for treatment using the TST36 stapler. RESULTS Forty-five patients were cured, 4 patients improved, and the cure rate was 92%. The postoperative obstructed defecation syndrome score, the defecation frequency score, time/straining intensity, and sensation of incomplete evacuation were significantly decreased compared with these parameters before treatment, and the differences were statistically significant (P < 0.05). The postoperative anal canal resting pressure and maximum squeeze pressure in patients decreased compared with before treatment, and the differences were statistically significant (P < 0.05). The initial and maximum defecation thresholds after surgery were significantly lower than those before treatment, and the differences were statistically significant (P < 0.05). The postoperative ratings of rectocele, resting phase, and defecation phase in these patients were significantly decreased compared with those before treatment, and the differences were statistically significant (P < 0.05). CONCLUSION The TST36 stapler is safe and effective in treating rectocele combined with internal rectal prolapse and is worth promoting in clinical work.