Aim The aim was to compare the pathological complete response (pCR) rate at 8 compared to 12 weeks’ interval between completion of neoadjuvant chemoradiotherapy (CRT) and surgery in patients with locally advanced rectal cancer. Method This was a randomized trial which included a total of 330 patients from two institutions. Patients with locally advanced (T3‐4N0M0, TxN+M0) rectal cancer were randomized into 8‐ and 12‐week interval groups. All the patients received long‐course CRT (45 Gy in 1.8 Gy fractions and concomitant oral capecitabine or 5‐fluorouracil infusion). Surgery was performed at either 8 or 12 weeks after CRT. The primary end‐point was pCR. Secondary end‐points were sphincter preservation, postoperative morbidity and mortality. Results Two‐hundred and fifty‐two patients (n = 125 in the 8‐week group, n = 127 in the 12‐week group) were included. Demographic and clinical characteristics were similar between groups. The overall pCR rate was 17.9% (n = 45): 12% (n = 15) in the 8‐week group and 23.6% (n = 30) in the 12‐week group (P = 0.021). Sphincter‐preserving surgery was performed in 107 (85.6%) patients which was significantly higher than the 94 (74%) patients in the 12‐week group (P = 0.016). Postoperative mortality was seen in three (1.2%) patients overall and was not different between groups (1.6% in 8 weeks vs 0.8% in 12 weeks, P = 0.494). Groups were similar in anastomotic leak (10.8% in 8 weeks vs 4.5% in 12 weeks, P = 0.088) and morbidity (30.4% in 8 weeks and 20.1% in 12 weeks, P = 0.083). Conclusion Extending the interval between CRT and surgery from 8 to 12 weeks resulted in a 2‐fold increase in pCR rate without any difference in mortality and morbidity.

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Glomus tumors in the gastrointestinal tract are unusual, as the previous series in the literature have been mainly limited to the stomach. Less than 10 cases of esophageal glomus tumors have been described in the literature. Oncocytic glomus tumors are a recently identified, rare variant of the glomus tumor. We report a 47-year-old female who presented with an approximately 3-month history of dysphagia and weight loss. Upper gastrointestinal endoscopy showed a black-purple, hypervascular, protruding lesion measuring approximately 65 mm at the 37th cm of the esophagus. The patient underwent an Ivor Lewis operation via open thoracotomy. The resected specimen had a protuberant, ulcerated mass measuring 80 × 35 mm in the posterior wall of the esophagus. Based on the histopathological, immunohistochemical and electron microscope findings, the final diagnosis was a malignant glomus tumor with oncocytic features. To our knowledge, this is the first report of a malignant glomus tumor with oncocytic features in an esophageal location.

BACKGROUND: We evaluated the feasibility of chitosan-coated sutures for intestinal anastomosis strength through wound-healing effect. METHODS: Vicryl and PDS sutures were coated with 2% chitosan. While laparotomy was applied to the first group, chitosan was applied in the peritoneal cavity in the second group. Then the following materials were applied to colon anastomosis, in order: Vicryl, PDS, chitosan-coated Vicryl, and chitosan-coated PDS sutures. On the 7 th and 14 th days, eight rats from each group were euthanized. RESULTS: The adhesion scores of chitosan and control groups were lower than the suture groups. The vascularization of Vicryl-chitosan was lower than PDS-chitosan on the 14 th day (p=0.038). Fibroblast cells and vascularization of anastomosis with chitosan-coated Vicryl were lower than Vicryl and chitosan-coated PDS on the 14th day (p<0.05). The tensile strength of Vicryl-chitosan increased more than Vicryl in vitro (p<0.05) on the 14 th and 7 th days, but there was no difference in vivo. The tensile strength of PDS-chitosan decreased more than PDS on the 7 th day in vivo (p<0.05). CONCLUSION: The chitosan-coating effect on the adhesion and reinforcement of anastomosis in some parts of Vicryl in vitro and PDS in vivo was slightly improved.