CACA guidelines for holistic integrative management of colon cancer （2024 Edition）has been updated with full reference to the latest research results at home and abroad，and the opinions of experts in related fields have been widely integrated. In the epidemiology section，the incidence and mortality rates of colorectal cancer have been updated according to the latest research data from the National Cancer Center. In the screening section，the starting age of screening for the general population has been changed to 45 years old. In the diagnosis section，peripheral blood MSI testing is included as one of the available options for patients with limited pathologic access. In the surgery section，it is recommended that experienced centers routinely perform CME procedures； additional clarification is provided on the safety of the procedure of taking specimens through the natural cavity. In the internal medicine section，evidence-based medical evidence for immunotherapy was added，recommending that immunotherapy be considered as a treatment option for patients with dMMR/MSI-H； the role of ctDNA in postoperative adjuvant therapy decision-making was described； immunotherapy was recommended as one of the therapeutic options for patients with liver metastases from MSI-H； and double-immunotherapy with nabulizumab in combination with ipilimumab was recommended as one of the available options for palliative care. In the section on traditional Chinese medicine，the “principle of evidence-based treatment” is adjusted to “principle of combining disease diagnosis and treatment with evidence-based treatment”，and the content of evidence-based treatment during the prevention and treatment of colon cancer is added，as well as the application of non-pharmacological therapies in traditional Chinese medicine.
This consensus focuses on summarizing the standardized diagnosis and treatment guidelines for rectal cancer in primary medical，aiming to provide scientific and standardized guidance for primary medical service institutions. The content covers the epidemiological characteristics，early screening，clinical manifestations，diagnostic criteria，and evaluation methods of rectal cancer. It also elaborates on treatment approaches，including surgery，radiotherapy，chemotherapy，and targeted therapy. The consensus highlights the critical role of primary medical workers in rectal cancer prevention and treatment，proposing diagnostic pathways and follow-up management recommendations. The goal is to improve the early diagnosis rate and treatment outcomes of rectal cancer at the primary medical service institutions，reduce patient mortality，and enhance patients' quality of life.
Small intestinal tumors，as a rare type of gastrointestinal tumor，have shown a continuous increase in incidence recent years. Due to the nonspecific clinical manifestations，it is easily confused with other gastrointestinal diseases，leading to difficulties in early detection and a high rate of delayed diagnosis. Moreover，the clinical diagnosis and treatment of small intestinal tumors are severely limited by the scarcity of available evidence. Therefore，the Colorectal Tumor Professional Committee of the Chinese Medical Doctor Association has organized multidisciplinary experts to compile the Chinese expert consensus on multidisciplinary comprehensive treatment of small intestinal tumors （2025 Edition）.This consensus integrates domestic and international research and clinical practice，focusing on the clinical characteristics，diagnostic criteria，treatment principles，and follow-up monitoring of small intestinal tumors.It aims to enhance the comprehensive diagnosis and treatment level of small intestinal tumors.
The intestine is known as the “second brain” of humans. There is a vicious cycle of mutual causality between intestinal and brain functions，and intestinal diseases are often accompanied by central nervous system degenerative diseases and mental and psychological disorders. The most important intermediate mediator is the intestinal flora. Abnormalities in the intestinal flora can not only directly lead to intestinal dysfunction，but also affect the function of the central nervous system through immune regulation and the synthesis and release of neurotransmitters. Abnormalities in the intestine and central nervous system can further lead to disorders in the intestinal flora. As a means of artificial regulation of the gut microbiota，fecal microbiota transplantation（FMT） is garnering increasing attention in the treatment of diseases related to the microbiota-gut-brain axis.
Functional intestinal disorders（FIDs） are common chronic gastrointestinal diseases with complex mechanisms involving the gut-brain axis，immune system，and gut microbiota. Recent studies indicate that gut microbiota imbalance plays a crucial role in the onset and exacerbation of FIDs，especially in subtypes such as irritable bowel syndrome （IBS），functional diarrhea，and constipation. Fecal microbiota transplantation（FMT），as a method to modulate gut microbiota，has gained increasing attention and shown significant efficacy in some clinical trials. However，challenges remain in the application of FMT，particularly regarding efficacy sustainability，safety，and individual variability. Additionally，adjunctive treatments，such as probiotics and prebiotics，are also believed to have synergistic effects in symptom improvement. Future research will explore the potential for combined application of FMT with probiotics and optimize therapeutic strategies to achieve personalized and precise management of FIDs.
To investigate the status quo of discharge readiness in patients with constipation treated by fecal microbiota transplantation（FMT） and analyze its influencing factors.
Methods
Convenience sampling method was used to select 120 constipation patients who underwent FMT treatment in a grade-A hospital in Shanghai from March 2024 to September 2024 as the study objects. General data questionnaire，discharge readiness scale，discharge guidance quality scale，self-rating anxiety scale and selfrating depression scale were used for questionnaire investigation.
Results
The total score of discharge readiness of patients with constipation treated by FMT was （93.75±12.85）. Multiple linear regression analysis showed that age（β=-0.163，P＜0.001），frequency of FMT（β=5.509，P＜0.001），anxiety state（β=-0.333，P＜0.001） and quality of discharge guidance（β=0.289，P＜0.001） were independent influencing factors of patients' discharge readiness through single factor screening.
Conclusion
In this study，the discharge readiness of patients with constipation treated by FMT is at a medium to low level. Medical staff should focus on patients with old age，FMT for the first time，anxiety and low quality of discharge guidance，and construct targeted discharge service programs to improve the discharge readiness of patients.
To compare the clinical efficacy of robotic and laparoscopic surgery for radical resection of sigmoid carcinoma.
Methods
A retrospective cohort study and propensity score assignment （PSM） were used to analyze the surgical efficacy of patients undergoing radical resection for sigmoid carcinoma in China-Japan Friendship Hospital of Jilin University from June 2019 to June 2024.The patients were divided into laparoscopic group and robotic group according to the inclusion criteria and the final surgical method selected. Among the 167 patients in the robotic group，and 334 patients in the laparoscopic group，PSM was used to match the basic data information related to age，gender，BMI，preoperative underlying diseases，preoperative ASA grade，tumor distance from anal margin，and TNM stage by 1：2，and the caliper value was 0.1. There were 112 patients in the post-PSM robot group and 224 patients in the laparoscopic group. There was no statistical significance in the comparison of baseline data between the two groups，and the differences in intraoperative and postoperative related conditions，complications，and pathological gains were studied between the two groups.
Results
The number of lymph node dissection in the robot group was significantly higher than that in the laparoscopic group （Z=-4.389，P＜0.001），and the amount of surgical bleeding was significantly lower than that in the laparoscopic group（Z=-4.948，P＜0.001）. The number of postoperative Clavien-Dindo grade II and above complications was significantly lower than that of the laparoscopic group （χ2=19.145，P＜0.001），and the proportion of postoperative hospital stay in total hospital stay was significantly lower than that of the laparoscopic group（Z=-3.896，P＜0.01）.
Conclusion
Compared with laparoscopically assisted radical resection of sigmoid carcinoma，robot-assisted radical resection of sigmoid carcinoma is more accurate，less invasive and faster postoperative recovery.
Slow transit constipation （STC） is a complex chronic functional gastrointestinal disorder involving intestinal motility dysfunction，abnormal neural regulation，and dysbiosis of the gut microbiota.In recent years，the role of the gut microbiota in the pathogenesis of STC has gained increasing attention.Studies have shown that the composition of the gut microbiota，its metabolites，and its interactions with the host immune system play a crucial role in the development and progression of STC. This review summarizes the relationship between the gut microbiota and STC，exploring the mechanisms by which the microbiota regulates neural function，inflammatory responses，and intestinal motility. Additionally，the potential of microbiota-based interventions，such as probiotics and fecal microbiota transplantation，in the treatment of STC is discussed，providing new insights and references for future research and clinical applications.
Chronic constipation，as a global functional disease of the digestive system，is on the rise globally，and is characterized by difficulty in defecation，decreased frequency of defecation，dry and hard stools，and anorectal blockage，which seriously affects patients' quality of life and psychological health.Among them，the imbalance of intestinal flora has gradually become a risk factor for chronic constipation.Plant-derived polysaccharides，however，have shown their potential in regulating intestinal flora and treating constipation due to their low toxicity，anti-inflammatory and immunomodulatory properties. This paper reviews the relationship between intestinal flora dysbiosis and chronic constipation，and explores the mechanism of action of plant-derived polysaccharides in regulating intestinal flora，improving intestinal function and constipation symptoms. It aims to provide reference for further research on intestinal flora and plant-derived polysaccharides in the treatment of constipation.
Radiation enteritis （RE） refers to the intestinal complications caused by radiation therapy for malignant tumors in the pelvic，abdominal，or retroperitoneal regions，and is one of the common complications in clinical radiation therapy. The gut microbiota is closely related to human health，and many studies support the crucial role of gut microbiota in the occurrence and development of RE. By regulating the balance of microbiota，the goal of preventing and assisting in the treatment of RE can be achieved. The author focuses on summarizing the relationship and related mechanisms between gut microbiota and RE，and explores the application of gut microbiota therapy in the clinical treatment of RE.
To provide a new strategy for selecting colorectal cancer cell lines that are compatible with the research objectives.
Methods
The transcriptome results of Berg et al. were analyzed using pathway variation analysis to characterize the pathway features of different colorectal cancer cell lines.
Results
Different cell lines exhibit diverse cancer pathway features. Similar pathway preferences may still exist between different subtypes of colorectal cancer cell lines.
Conclusion
The selection of colorectal cancer cell lines has great research value and we provides with a new perspective on the biological behavior of tumor cell lines.
To evaluate the effectiveness of the “Skin bridge loop ileostomy” technique in radical resection for low rectal cancer，and to share our clinical insights gained from this approach.
Methods
We prospectively collected 184 patients who underwent laparoscopic radical resection for low rectal cancer and received prophylactic ileostomy at the terminal ileum using the “skin - bridge loop ileostomy”. All patients were followed up，relevant clinical data were statistically analyzed，and postoperative complications were observed. The common stoma-related problems in the peri-operative period of this method were analyzed and discussed.
Results
Ileostomy was performed in 184 patients with a median duration of 5 min. Ileostomy reduction was performed in 118 patients with a median duration of 48 min，of which 54 patients underwent ileostomy reduction at 6 months postoperatively，with a median duration of 47 min.Sixty-four patients underwent ileostomy reduction at more than 6 months postoperatively，with a median duration of 53.5 min. A total of 27 patients （14.67%） experienced stoma-related complications. Among them，fifteen patients （8.15%） stoma skin-mucosal separation，six patients （3.26%） developed parastomal hernia，ten patients （5.43%） developed peristomal dermatitis，four patients （2.17%） developed stoma hemorrhage，and 2 patient （1.09%） developed stoma stenosis.
Conclusion
The “skin bridge loop ileostomy” technique in radical resection for low rectal cancer has a short operation time. The incidence of stoma - related complications is relatively low. However，attention should be paid to the details of this operation.
The application of robot-assisted laparoscopic simultaneous resection of descending colon cancer with metastasis to the right posterior lobe of the liver is uncommon. We report a case of a 61-year-old male patient with descending colon cancer complicated by a solitary metastatic lesion in the right posterior lobe of the liver. Due to the large size of the hepatic metastatic tumor and high surgical risk，the patient underwent successful conversion therapy before simultaneous resection with robot-assisted laparoscopy. The same surgical port was utilized for both hepatic and intestinal lesions. The total operative time was 300 minutes，with an intraoperative blood loss of 400 mL. The patient had a good recovery postoperatively，with no complications. Da Vinci robotic surgery can safely and effectively perform minimally invasive surgical procedures for solitary metastasis of descending colon cancer to the liver.
