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  • 1.
    CACA guidelines for holistic integrative management of cancer-Rectal cancer
    China Anti-Cancer Association, Colorectal Cancer Professional Committee, Chinese Anti⁃Cancer Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (02): 89-103. DOI: 10.3877/cma.j.issn.2095-3224.2022.02.001
  • 2.
    Guidelines for natural orifice specimen extraction surgery in colorectal neoplasm (V. 2023)
    Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association, Colorectal Cancer Professional Committee of the China Anti-Cancer Association, China NOSES Alliance
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2023, 12 (02): 89-99. DOI: 10.3877/cma.j.issn.2095-3224.2023.02.001
    Abstract (1057) HTML (58) PDF (1242 KB) (213)

    Natural orifice specimen extraction surgery (NOSES) has become an important part of minimally invasive surgery. Compared with other types of cancers, NOSES has the earliest initiation, fastest development, most detailed theory, and most sophisticated techniques in the application of colorectal neoplasms. To ensure the standardized development and promotion of NOSES surgery in clinical practice, the Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association, the Colorectal Cancer Professional Committee of the China Anti-Cancer Association, and the China NOSES Alliance elaborated comprehensively on several aspects such as the definition, classification, nomenclature of surgical procedures, surgical principles, indications and contraindications, surgical technique practice, prevention and management of complications, clinical research, and technical standardization training based on the "Expert Consensus on NOSES Surgery for Colorectal Cancer (2019 version)."

  • 3.
    CACA guidelines for holistic integrative management of cancer-Colonic cancer
    China Anti-Cancer Association, Colorectal Cancer Professional Committee, Chinese Anti⁃Cancer Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (01): 1-12. DOI: 10.3877/cma.j.issn.2095-3224.2022.01.001
    Abstract (884) HTML (43) PDF (3228 KB) (203)
  • 4.
    Chinese expert consensus on targeted therapy for colorectal cancer
    Colorectal Cancer Committee of Chinese Medical Doctor Association, Colorectal Cancer Professional Committee of Chinese Anti-Cancer Association, Expert Committee on Quality Control of Colorectal Cancer of Center National Cancer/National Cancer Quality Control Center
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (05): 353-360. DOI: 10.3877/cma.j.issn.2095-3224.2022.05.001
    Abstract (1237) HTML (34) PDF (1081 KB) (186)

    In recent years, with the application of new targeted drugs, it has become a first-line scheme for individualized and comprehensive treatment of colorectal cancer. Colorectal Cancer Committee of Chinese Medical Doctor Association, Colorectal Cancer Professional Committee of Chinese Anti-Cancer Association, Expert Committee on Quality Control of Colorectal Cancer of Center National Cancer/National Cancer Quality Control Center organized many experts nationwide to discuss the standardized application of colorectal cancer targeted drugs.

  • 5.
    Chinese expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastases (2022 edition)
    Professional Committee of Peritoneal Metastasis, Colorectal Cancer Committee of Chinese Medical Doctor Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (04): 265-271. DOI: 10.3877/cma.j.issn.2095-3224.2022.04.001
    Abstract (1366) HTML (36) PDF (881 KB) (170)

    Colorectal cancer (CRC) has the second highest incidence and the fourth highest mortality rate among malignant tumors in China. Being common metastatic site, peritoneum metastases have high incidence, are difficult to diagnose early, and have a poor prognosis. Since the diagnosis and treatment of peritoneal metastases from colorectal cancer has not formed a standardized pattern, in 2017, the Colorectal Cancer Committee of the Chinese Medical Doctor Association organized relevant authoritative experts to formulate the Chinese expert opinion on the diagnosis and treatment of colorectal cancer peritoneal metastases(2017), which played a positive role within the profession.In the past few years, more and more attention has been paid to peritoneal metastases of colorectal cancer, and a series of clinical trials have been carried out and some experiences have been accumulated.Therefore, the committee has revised the 2017 edition of the Chinese expert opinion on the diagnosis and treatment of colorectal cancer peritoneal metastases and formulated the 2022 edition of the Chinese expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastases.In order to guide and standardize the diagnosis and treatment of colorectal cancer peritoneal metastases, develop a rational and effective comprehensive treatment option, prolong the survival time and improve the quality of life of patients, and improve the overall diagnosis and treatment level of colorectal cancer in China.

  • 6.
    Expert consensus of natural orifice specimen extraction surgery in colorectal neoplasm (2019)
    China NOSES Alliance, Professional Committee of Natural Orifice Specimen Extraction Surgery, Colorectal Cancer Committee of Chinese Medical Doctor Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2019, 08 (04): 336-342. DOI: 10.3877/cma.j.issn.2095-3224.2019.04.003
    Abstract (637) HTML (83) PDF (987 KB) (157)

    Recently, natural orifice specimen extraction surgery (NOSES) have been developed rapidly in China. ″Chinese consensus of NOSES in colorectal neoplasm (2017)″ and ″International consensus of NOSES in colorectal neoplasm (2017)″ were published, which played important roles in regulating clinical practice of NOSES in China and even all over the world. However, with the improvment of NOSES, the colorectal NOSES has experienced an great progress. In this context, based on the consensus of 2017, the new verson of ″Chinese consensus of NOSES in colorectal neoplasm (2019)″ is revised and published, the theoretical and technical system of NOSES for colorectal cancer is improved in this new consensus in order to better guide clinical practice.

  • 7.
    Precision functional sphincter-preserving surgery (PPS) for low rectal cancer using screw-thread anal dilator
    Chengle Zhuang, Xianzhong Zhang, Qian Liu, Zhongchen Liu
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2019, 08 (05): 509-512. DOI: 10.3877/cma.j.issn.2095-3224.2019.05.014
    Abstract (118) HTML (8) PDF (1655 KB) (149)
    Objective

    To explore the safety and advantages of using our new self-made transparent screw-thread anal dilator in the treatment of ultra-low rectal cancer through natural orifice specimen extraction surgery (NOSES).

    Methods

    Retrospective analysis of 5 cases in which patients underwent the laparoscopy combined with transanal manual anastomosis precision functional sphincter-preserving NOSES surgery (PPS) for Ultra-Low Rectal Cancer using the new screw-thread anal dilator between May 2018 to June 2018 at Gastrointestinal Surgery Department, Shanghai Tenth People's Hospital. A summary was made of the patients' operation time, intraoperative bleeding volume, length of hospital stay, complications and anal function.

    Results

    The PPS for Ultra-Low Rectal Cancer was successfully completed in all 5 patients. The average operation time was (217.01±37.75) min, the average intraoperative bleeding volume was (108.32±53.15) mL, the average length of hospital stay after operation was (6.34±1.72) days, average Wexner and Vaizey scores for anal function after operation were 3 points, and no significant complications occurred after operation.

    Conclusion

    Using the new screw-thread anal dilator in the treatment of ultra-low rectal cancer through PPS has proven to be safe and effective. Incision of abdomen to extract specimen was avoided, and the surgical trauma was significantly reduced. At the same time, the lesion can be precisely resected under direct vision, with post-operative anal function being preserved and improved to a great extent, thus improving quality of life after operation. Moreover, the device is operable, economical and practical; indeed, it is worth promoting and applying in clinic. However, the above conclusions still need to be further validated by clinical studies with large sample sizes.

  • 8.
    Chinese experts consensus on multidisciplinary comprehensive treatment of appendiceal neoplasm (2021 version)
    Colorectal Cancer Committee of Chinese Medical Doctor Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2021, 10 (03): 225-231. DOI: 10.3877/cma.j.issn.2095-3224.2021.03.001
    Abstract (905) HTML (32) PDF (705 KB) (136)

    Nowadays, as the result of there is few evidence available for the diagnosis and treatment of appendiceal neoplasm, clinicians have not reached a consensus on it. In this case, Colorectal Cancer Committee of Chinese Medical Doctor Association organized multidisciplinary experts to develop Chinese experts consensus on multidisciplinary treatment of appendiceal neoplasms (2021 version) focusing on the issues and dispute of clinical characteristics, diagnosis, treatment and follow-up monitoring by synthesizing domestic and foreign research and clinical practice. The purpose of this consensus is to provide more detailed multidisciplinary treatment strategies for clinicians to treat appendiceal neoplasm.

  • 9.
    Expert consensus on perioperative management of elderly patients with colorectal cancer in China (2020 Edition)
    The Chinese Society of Colorectal Cancer
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2020, 09 (04): 325-334. DOI: 10.3877/cma.j.issn.2095-3224.2020.04.001
    Abstract (743) HTML (51) PDF (932 KB) (124)

    Colorectal cancer is a malignancy with high incidence, and its incidence increases with age. Each year 50% of new colorectal cancer patients are over 70 years old worldwide, and 25% of new colorectal cancer patients are over 80 years old. Preoperatively, elderly patients are more likely to have complications and thus have a higher perioperative risk. In addition, elderly patients are often accompanied with more advanced local tumor lesions, which frequently caused intestinal obstruction or lesion metastasis at the time of consultation, resulting in more difficult surgeries. It has been established that advanced age is an independent risk factor for increased perioperative mortality and mobility. Therefore, in order to cope better with the challenges of perioperative management of elderly colorectal cancer patients, this expert consensus on perioperative management of elderly patients with colorectal cancer is developed by the experts of the Perioperative Medicine Special Committee of the Chinese Society of Colorectal Cancer. And this expert consensus included preoperative, intraoperative and postoperative stages of perioperative periods. And comprehensive preoperative evaluations in elderly colorectal cancer patients, rehabilitation measures, lung protective ventilation strategy, goal-directed fluid therapy, regional analgesia management and prevention and treatment of postoperative cognitive dysfunction are all discussed in this expert consensus. Therefore, this expert consensus further improves the perioperative management level of elderly colorectal cancer patients, speeds up postoperative rehabilitation and improves the prognosis of elderly colorectal cancer patients.

  • 10.
    Chinese experts consensus on multidisciplinary treatment of brain metastases from colorectal cancer (2020 version)
    Colorectal Cancer Committee of Chinese Medical Doctor Association.
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2020, 09 (02): 109-114. DOI: 10.3877/cma.j.issn.2095-3224.2020.02.001
    Abstract (356) HTML (24) PDF (1312 KB) (120)

    The patients with brain metastasis from colorectal cancer has a poor prognosis, and the current guidelines for the diagnosis and treatment of brain metastasis have not yet reached a unified consensus. Therefore, based on the guidelines for the diagnosis and treatment of metastatic colorectal cancer, the Chinese Colorectal Cancer Committee organized multi-disciplinary experts to integrate the relevant studies and combine with clinical practices, aiming at the issues and controversies about clinical characteristics, diagnosis and treatment, and follow-up of brain metastasis patients from colorectal cancer. After discussion and voting, Chinese experts consensus on multidisciplinary treatment of brain metastases from colorectal cancer (2020 version) was formed. This consensus could provide better guidance for clinicians and maximize the control of the patient's condition, improve the quality of life and prolong the survival time.

  • 11.
    Expert consensus on robotic natural orifice specimen extraction surgery for colorectal neoplasm
    Professional Committee of Natural Orifice Specimen Extraction Surgery, Colorectal Cancer Committee of Chinese Medical Doctor Association, Professional Committee of Robotic Surgery, Colorectal Cancer Committee of Chinese Medical Doctor Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (03): 177-191. DOI: 10.3877/cma.j.issn.2095-3224.2022.03.001
    Abstract (419) HTML (45) PDF (4438 KB) (119)

    Robotic minimally invasive surgery and natural orifice specimen extraction surgery (NOSES) have been important trends in the surgical modalities of colorectal tumor. NOSES performed on robotic platform, incorporating the merits of both, has drawn extensive concern from colorectal surgeons. Robotic NOSES is in the early stages of implementation. There is no consensus on standards in clinic. Consequently, an expert consensus is urgently needed for scientific and standardized guidance for robotic NOSES in colorectal tumor, which is of significant importance for the development of robotic NOSES.

  • 12.
    Chinese expert consensus on the pelvic exenteration for primary rectal cancer beyond total mesorectal excision planes and locally recurrent rectal cancer (2023 edition)
    China PelvEx Collaborative, Colorectal Cancer Committee of the Chinese Medical Doctor Association, Gastrointestinal Surgery Committee of China International Exchange and Promotive Association for Medical and Health Care
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (06): 441-451. DOI: 10.3877/cma.j.issn.2095-3224.2022.06.001
    Abstract (323) HTML (33) PDF (8118 KB) (119)

    Pelvic exenteration is often required for primary rectal cancer beyond totalmesorectal excision (PRC-bTME) and locally recurrent rectal cancer (LRRC). Some patients with radical resection can achieve long-term survival, but they need to face risks, such as huge surgical trauma, serious perioperative complications, permanent loss of organ function and decline in quality of life. The preoperative evaluation of PRC-bTME and LRRC should emphasize multidisciplinary collaboration, and develop individualized diagnosis and treatment strategies. The principles of function preservation in oncology surgery and risk-benefit balance should be followed, and R0 resection should be emphasized. Perioperative complications, surgical trauma and organ function loss should be minimized to achieve the best quality control and balance point. This consensus was formulated by the Colorectal Cancer Committee of the Chinese Medical Doctor Association and the Gastrointestinal Surgery Committee of China International Exchange and Promotive Association for Medical and Health Care. The draft was formed based on the summary of domestic and foreign research progress and expert experience. After discussion, review and modification by experts, a secret ballot was conducted for each major opinion, and in-depth demonstration was carried out according to the principles of evidence-based medicine. Finally, the Chinese expert consensus on the pelvic exenteration with primary rectal cancer beyond total mesorectal excision planes and locally recurrent rectal cancer (2023 edition) was formed. This consensus mainly summarizes the indications and contraindications of PE for PRC-bTME and LRRC, preoperative diagnosis and evaluation, perioperative treatment, as well as the resection scope, surgical methods, reconstruction of related organs, safety and complications of PE, postoperative follow-up and other issues, in order to provide guidance for PRC-bTME and LRRC to perform PE.

  • 13.
    CACA guidelines for holistic integrative management of cancer-Anal cancer
    China Anti-Cancer Association, Colorectal Cancer Professional Committee, Chinese Anti⁃Cancer Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (01): 13-17. DOI: 10.3877/cma.j.issn.2095-3224.2022.01.002
    Abstract (521) HTML (33) PDF (976 KB) (117)
  • 14.
    Medication options for colorectal cancer with complications
    Wentong Fang, Yanhong Gu
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2018, 07 (05): 420-430. DOI: 10.3877/cma.j.issn.2095-3224.2018.05.004
    Abstract (68) HTML (2) PDF (1241 KB) (100)

    Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in China and worldwide. CRC accompany with other system diseases or insufficiency, such as kidney insufficiency, liver insufficiency, hepatitis, cardiovascular disease, agedness or weakness is not uncommon. Complications may affect the treatment choices of CRC, while CRC therapies also have an effect the complications. We overviewed the effect of complications on pharmacokinetics and pharmacodynamics of drug therapy, and discussed the optimal medication for these patients.

  • 15.
    Chinese expert consensus for prophylactic and therapeutic intraperitoneal medication for peritoneal metastases from colorectal cancer (2019 edition)
    Professional Committee of Peritoneal Metastasis, Colorectal Cancer Committee of Chinese Medical Doctor Association
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2019, 08 (04): 329-335. DOI: 10.3877/cma.j.issn.2095-3224.2019.04.002
    Abstract (440) HTML (31) PDF (856 KB) (96)

    The morbidity and mortality of colorectal cancer increaserecently in China. Peritoneal, as a common site of metastasis, is one of the typical causes of treatment failure. Although there are many kinds of peritoneal prophylactic and therapeutic drugs for peritoneal metastasis of colorectal cancer, the dose and time of action have not yet formed a standardized treatment model. In order to standardize intraoperative prophylactic and therapeutic intraperitoneal intervention methods, the experts from Professional Committee of peritoneal metastasis and Colorectal Cancer Committee of Chinese Medical Doctor Association developed "Chinese expert consensus for prophylactic and therapeutic intraperitoneal medication for peritoneal metastases from colorectal cancer". It aims at improving the overall diagnosis and treatment of colorectal cancer, extend the survival time of patients and improve the quality of life.

  • 16.
    Chinese experts consensus on the management of ovarian metastases from colorectal cancer (2020 version)
    Colorectal Cancer Committee of Chinese Medical Doctor Association.
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2020, 09 (02): 115-121. DOI: 10.3877/cma.j.issn.2095-3224.2020.02.002
    Abstract (288) HTML (40) PDF (1426 KB) (94)

    Colorectal cancer is one of the major causes of morbidity and mortality in China. Ovarian metastasis from primary colorectal cancer is an uncommon condition for female patients. With insidious symptoms and poor sensitivity to conventional chemotherapy, the clinical treatment of ovarian metastasis remains controversial. Therefore, experts from Chinese Colorectal Cancer Committee developed "Chinese experts consensus on the management of ovarian metastases from colorectal cancer", which aims to standardize the diagnosis and treatment of patients with colorectal cancer ovarian metastases, improve the quality of management, prolong the survival, as well as improve the quality of life.

  • 17.
    China guideline for diagnosis and comprehensive treatment of colorectal liver metastases (version 2023)
    Chinese College of Surgeons, Section of Gastrointestinal Surgery, Branch of Surgery, Chinese Medical Association, Section of Colorectal Surgery, Branch of Surgery, Chinese Medical Association, Colorectal Cancer Professional Committee, Chinese Anti-Cancer Association, Colorectal Cancer Professional Committee, Chinese Medical Doctor Association, Colorectal Cancer Expert Committee, Chinese Society of Clinical Oncology, Chinese Society of Colon & Rectal Surgeons, Chinese College of Surgeons, Chinese Medical Doctor Association, Metastasis Research Committee, Anorectal Branch of Chinese Medical Doctor Association, Section of Colorectal Oncology, Oncology Branch, Chinese Medical Association, Branch of Metastatic Tumor Therapy, China International Exchange and Promotive Association for Medical and Health Care, Branch of Colorectal Disease, China International Exchange and Promotive Association for Medical and Health Care
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2023, 12 (01): 1-16. DOI: 10.3877/cma.j.issn.2095-3224.2023.01.001
    Abstract (1041) HTML (28) PDF (2363 KB) (85)

    The liver is the main target organ for hematogenous metastases of colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment of colorectal cancer. In order to improve the diagnosis and comprehensive treatment in China, the Guidelines have been edited and revised for several times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, increase the local damage rate of liver metastases, prolong long-term survival, and improve quality of life. The revised Guideline version 2023 includes the diagnosis and follow-up, prevention, multidisciplinary team (MDT), surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment, with state-of-the-art experience and findings, detailed content, and strong operability.

  • 18.
    The completely abdominal approach to intersphincteric resection (ISR) with the preservation of left colic artery for rectal cancer
    Lixiong Luo, Guancong Wang, Kaiyuan Yao, Zhizong Zheng, Yincong Guo
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2023, 12 (02): 172-176. DOI: 10.3877/cma.j.issn.2095-3224.2023.02.014
    Abstract (1721) HTML (157) PDF (1033 KB) (80)

    Intersphincteric resection (ISR) is an ultra-low sphincter- preserving operation. The completely abdominal approach to ISR has rarely been reported. This surgical procedure was successfully performed in our hospital, aiming to discuss the operation criterion.

  • 19.
    Two case reports of colorectal patients with perfect combination of enhanced recovery after surgery and natural orifice specimen extraction surgery
    Hongming Li, Dechang Diao, Yisen Ke, Jie Li, Xiaojiang Yi, Xinquan Lu, Chenhui Deng, Kuishun Shan, Jin Wan
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2020, 09 (05): 521-524. DOI: 10.3877/cma.j.issn.2095-3224.2020.05.016
    Abstract (114) HTML (5) PDF (1016 KB) (76)

    Natural orifice specimen extraction surgery (NOSES) and enhanced recovery after surgery (ERAS) are the current hot topic in the field of abdominal minimally invasive surgery. The multidisciplinary and multimodal approach consists of the whole course management of preoperative preparation, anesthesia and analgesia, minimally invasive surgery and postoperative rehabilitation with the core principle of reducing surgical trauma and stress, accelerating recovery. Recently, our team has made efforts to explore the effect of optimal combination of minimal invasive surgery, precise anesthesia, whole-course pain management, as well as strict preoperative preparation and postoperative follow-up to minimize the physical and mental stress and trauma of surgical patients.

  • 20.
    Clinical significance and recognition for left hemi-colon angiotomy
    Jing Zhuang
    Chinese Journal of Colorectal Diseases(Electronic Edition) 2022, 11 (06): 459-464. DOI: 10.3877/cma.j.issn.2095-3224.2022.06.003
    Abstract (396) HTML (14) PDF (6491 KB) (69)

    Left hemi-colon has special bidirectional arterial blood supply, and its lymphatic drainage can drain to the superior mesenteric vessels and inferior mesenteric vessels at the same time. The blood supply of left hemi-colon depends on branch vessels of inferior mesenteric artery(IMA) and middle colic artery(MCA), and high vascular variation brings uncertainty about the dominant vessels and the direction of the main lymphatic drainage. Recently, in addition to the middle colic and left colic artery(LCA),the accessory middle colic artery (AMCA) has been recognized as a feeding artery for the left hemi-colon. Surgery for located in the left hemi-colon cancer is difficult to perform because of the complex anatomy of high vascular variation. In the radical resection of left colon cancer, adequate mobilization of the colon is particularly important to meet the sufficient resection margin and the root ligation of both sides of the blood supply vessels. The anatomical understanding of left hemi-colon vessels provides a theoretical basis for vascular management and lymph node dissection in radical resection of left hemi-colon cancer.

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