CACA guidelines for holistic integrative management of rectal cancer （2024 Edition）fully refers to the latest researches at home and abroad， integrates experts' opinions in relevant fields and forms an updated version.In the epidemiology section， according to the latest data of the National Cancer Center， the detailed data of incidence and mortality of colorectal cancer were updated.In the screening section， the beginning age for general population screening has changed to 45 years old.In the surgical section， novel evidences have been added to total mesocolectomy， natural orifice specimen extraction surgery， “robotic” surgery and transanal total mesorectal excision.In the internal medicine section， novel evidences have been added to immunotherapy， and it is recommended that patients with dMMR/MSI-H status can consider immunotherapy.Besides， based on the latest researches， the chemotherapy cycles for high-risk stage Ⅱ patients and low-risk stage Ⅲ patients have been updated.In the radiotherapy section， the principles of preoperative neoadjuvant chemoradio-therapy were refined and reset， and different plans were developed based on tumor staging， microsatellite status and anal preservation intention.The principles of combined chemoradiotherapy for rectal cancer and the opportunity of surgery after chemoradiotherapy were also updated.In the traditional Chinese medicine section， the principle of “treatment based on syndrome differentiation” has been changed to “the combination of treatment based on disease differentiation and treatment based on syndrome differentiation”.At last， the current edition have added “treatment based on syndrome differentiation during rectal cancer follow-up period” section and the application of nonpharmacological therapies in traditional Chinese medicine.

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.

Colorectal cancer is one of the most common malignant tumors in China， ranking second in morbidity and fourth in mortality. Metastasis and recurrence are the leading causes of patient death， and the peritoneum is a frequent site of metastasis in colorectal cancer， second only to liver and lung metastases. However， the prognosis of peritoneal metastasis is much worse than hepatic and pulmonary metastasis. Colorectal cancer peritoneal metastasis is characterized by difficult early diagnosis， severe symptoms and poor prognosis. Its standardized diagnosis and treatment are crucial for improving the prognosis of patients and enhancing their quality of life. The Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association organized authoritative experts in the field of colorectal cancer in China to compile the “Chinese Expert Consensus on the Diagnosis and Treatment of Colorectal Cancer Peritoneal Metastasis （2017 Edition）” as early as 2017， and revised it in 2022. In view of the research progress of colorectal cancer peritoneal metastasis， the Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association organized domestic multidisciplinary experts to revise and update the “Chinese Expert Consensus on the Diagnosis and Treatment of Colorectal Cancer Peritoneal Metastasis （2017 Edition）” and the 2022 revision based on the latest research results and evidence-based medical evidence after repeated discussions. The “Expert Consensus on the Diagnosis and Treatment of Peritoneal Metastasis of Colorectal Cancer （2025 Edition）” was compiled， reaching a preliminary consensus on the definition， diagnosis，treatment and prevention of colorectal cancer peritoneal metastasis， with the aim of guiding and standardizing the diagnosis and treatment of colorectal cancer peritoneal metastasis， developing reasonable and effective comprehensive treatment plans， prolonging survival time and improving quality of life for colorectal cancer peritoneal metastasis patients， thereby raising the overall level of diagnosis and treatment for colorectal cancer in China.

The incidence of low rectal cancer continues to rise annually， the research on low rectal cancer and the innovation of technology are constantly advancing and deepening. The new neoadjuvant treatment strategies and anus-preserving surgical plans formulated based on the multidisciplinary team （MDT）scheme closely affect the perioperative management， functional preservation effect， and long-term quality of life of patients. This consensus document establishes standardized multidisciplinary integrated care pathways for preoperative management， aiming to systematize clinical decision-making processes and promote standardized implementation across clinical practice.

Objective

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.

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.

Objective

To systematically evaluate the efficacy and safety of Ferguson Hemorrhoidectomy （Closed） versus Milligan-Morgan Hemorrhoidectomy （Open） for the treatment of mixed hemorrhoids and to provide an evidence-based basis for surgical protocols.

Methods

CNKI， Wanfang，WIP， CBM and PubMed databases were searched to collect randomized controlled trials （RCTs） of closed hemorrhoidectomy （the study group） versus open hemorrhoidectomy （the control group）， and the years of searching were from January 2000 to May 2024.The quality of the literature was assessed using the bias assessment tool recommended by Cochrane Systematic Reviews after screening and extracting the literature information； Meta-analysis， sensitivity analysis， publication bias analysis and regression analysis were done using STATA 17.0 software.

Results

A total of 30 RCTs with 3 505 patients were included.Meta-analysis showed that compared with open hemorrhoidectomy， closed hemorrhoidectomy had a higher cure rate ［RR=1.16，95% CI （1.08～1.25）， P＜0.01］， shorter wound healing time ［SMD= -1.90， 95%CI （ -2.32～ -1.48）， P＜0.01］，shorter operative time ［SMD= -2.68， 95%CI （ -4.70～ -0.65）， P=0.01］， less intermediate bleeding ［SMD=-6.94， 95%CI（ -10.96～ -2.91）， P＜0.01］， and lower VAS scores on the first postoperative bowel movement［SMD= -0.85， 95%CI （ -1.42～ -0.29）， P＜0.01］， lower probability of postoperative bleeding ［RR=0.65，95%CI （0.51～0.82）， P＜0.01］， shorter hospital stay ［SMD= -0.92， 95%CI （ -1.63～ -0.22）， P=0.01］ and less frequent postoperative bowel difficulties ［RR=0.24， 95%CI （0.07～0.81）， P=0.02］， but the probability of postoperative trabecular dehiscence was higher ［RR=7.66， 95%CI （2.56～22.97）， P＜0.01］.The differences in the rates of trabecular infection， postoperative pain， edema， urinary retention， anal fissure， anal cleanliness，anal stenosis， 24-hour postoperative VAS scores， return to work time， and recurrence rates between the two surgical procedures were not statistically significant （all P＞0.05）.The results of sensitivity analysis showed that the robustness of the results of this study was good.The risk of publication bias analysis showed the possibility of publication bias.

Conclusion

The overall efficacy of closed hemorrhoidectomy is better than open hemorrhoidectomy.Closed hemorrhoidectomy has a higher cure rate， shorter wound healing time， and does not increase the rate of wound infection or anal stenosis， making it a safe and effective procedure.

Colorectal cancer liver metastasis （CRLM） is the most important cause of death in colorectal cancer patients， which seriously threatens the life safety of people and hinders the prosperity and development of society and economy.With the increasing incidence of colorectal cancer in our country，the harm of CRLM is becoming more and more obvious.In this context， how to establish a scientific and effective CRLM model to promote the in-depth understanding of the tumor invasion and metastasis process，reveal the corresponding mechanism， evaluate the effect of different diagnosis and treatment schemes， and finally realize the early prevention and treatment of CRLM should be the focus and difficulty of current research.Traditional CRLM models include carcinogen induction model， orthotopic model， heterotopic model，xenogenic implantation model and genetically engineered mouse model.In recent years， with the continuous progress of science and technology， new modeling methods such as microfluidic chip model have emerged，providing more updating options.In this paper， relevant literature at home and abroad was reviewed， and the advantages and disadvantages of traditional mouse models and emerging modeling methods were discussed in depth， aiming to compare the advantages and disadvantages of each modeling method and introduce the latest research results， so as to provide certain guidance for the scientific establishment of CRLM model and ultimately bring more scientific personalized treatment for CRLM patients.

Colorectal cancer is one of the most common malignant tumors in China， and its treatment is mainly based on surgical operation， combined with radiotherapy， chemotherapy and targeted therapy. In recent years， natural orifice specimen extraction surgery（NOSES） has attracted much attention in the field of minimally invasive surgery， and its therapeutic value for colorectal tumors is increasingly significant. This article reports a case of laparoscopic right hemicolectomy with specimen extraction through the anus without abdominal auxiliary incision， and analyzes and discusses the technical concept and key points of this operation.

Hemorrhoids are the most common anorectal diseases.He'nan Province has a large population， and it is estimated that more than 30 million people in the province suffer from hemorrhoids.In order to improve the comprehensive understanding and diagnosis and treatment level of primary medical staffin Henan Province， also to provide specific and feasible diagnosis and treatment norms for primary medical institutions， the He'nan Provincial Medical Doctor Association， the Committee of Colorectal Anal Surgeons，based on the search and reading of relevant literatures， with reference to China Hemorrhoid Diagnosis and Treatment Guide （2020）， combined with the actual situation of primary medical institutions and medical personnel in He'nan Province， the definition， classification， epidemiology， etiology， pathogenesis， diagnosis，differential diagnosis， referral recommendations， treatment， disease management and other aspects of hemorrhoids were comprehensively elaborated.

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.

Objective

To analyze and explore the risk factors for early stoma complications in patients with colorectal cancer after surgery and to construct a visual prediction model.

Methods

This study retrospectively collected and analyzed the clinicopathological data and related surgical information of colorectal cancer patients who underwent enterostomy in the Department of Gastrointestinal Surgery of the Second Affiliated Hospital of Soochow University from January 2018 to January 2021. The Logistic regression analyses were used to identify independent risk factors for stoma complications. Subsequently，a nomogram was constructed， and the model was validated through 1 000 bootstrap resamples based on the Bootstrap method. A receiver operating characteristic （ROC） curve was plotted， and the accuracy and clinical applicability of the nomogram prediction model were evaluated by calculating the area under the curve （AUC），Hosmer-Lemeshow goodness-of-fit test， calibration curve， and decision curve analysis （DCA）.

Results

A total of 267 stoma patients were ultimately included in the analysis， among which 71 patients observed varying degrees of stoma complications. The multivariate Logistic regression results showed that age （OR=0.040，P=2.509）， BMI （OR=5.119， P＜0.001）， serum albumin （OR=0.168， P＜0.001）， skin folds （OR=9.854， P＜0.001），and history of abdominal surgery （OR=23.331， P＜0.001） were independent predictors of early complications in stoma patients （P＜0.05）. A nomogram model was constructed based on these five independent predictors.The AUCs for the training set and validation set were 0.880 （95%CI: 0.820～0.940） and 0.861 （95%CI:0.770～0.953）， respectively. The Hosmer-Lemeshow test showed good agreement between the prediction model and the actual incidence of stoma complications （P＞0.05）. The DCA curve indicated that the model had a high net benefit.

Conclusion

The predictive model demonstrates good performance， aiding healthcare providers in promptly identifying the risk of early complications in patients with intestinal stomas and facilitating timely interventions.