The New Concepts and Challenges of Surgery for Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGXiao-dong ,  LILi

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

LILi, Email: drlili116@126.com

Keywords：

Colorectal cancer; Sphincter-saving operation; Fast track; Complication; Operative risk; Data

DOI：

10.7507/1007-9424.20140187

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explain the latest concepts of colorectal surgery, and predict the future direction of it. Methods A review and summary based on the clinical experience of our hospitals and theses over the past years and new advances on the researches in home and abroad were performed. Results Doctors should attach more importance to anal preserving operation; and there should be more usage of fast track in colorectal surgery. Besides, predicting low risk of postoperative complications and digitizing colorectal surgery also needed more attention. Conclusion Those aspects of colorectal surgery in the result need further development.

Citation： WANGXiao-dong, LILi. The New Concepts and Challenges of Surgery for Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(6): 782-786. doi: 10.7507/1007-9424.20140187 Copy

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2.	Thomas RM, Sobin LH.Gastrointestinal cancer[J].Cancer, 1995, 75(1 Suppl):154-170.
3.	郑树.我国大肠癌防治研究的挑战与机遇[J].浙江大学学报:医学版, 2004, 33(5):375-378.
4.	汪建平.中国结直肠癌治疗现状——进步与局限并存[J].中华胃肠外科杂志, 2012, 15(10):989-992.
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7.	陈琼,刘志才,程兰平,等.2003~2007年中国结直肠癌发病与死亡分析[J].中国肿瘤, 2012, 21(3):179-182.
8.	张静,马小琴.大肠癌患者的心理一致感、社会支持及生活质量的研究进展[J].解放军护理杂志, 2013, 30(8):39-41.
9.	Heald RJ, Husband EM, Ryall RD.The mesorectum in rectal cancer surgery-the clue to pelvic recurrence?[J].Br J Surg, 1982, 69(10):613-616.
10.	Schiessel R, Karner-Hanusch J, Herbst F, et al.Intersphincteric resection for low rectal tumours[J].Br J Surg, 1994, 81(9):1376-1378.
11.	Maurer CA, Renzulli P, Kull C, et al.The impact of the introduction of total mesorectal excision on local recurrence rate and survival in rectal cancer:long-term results[J].Ann Surg Oncol, 2011, 18(7):1899-1906.
12.	Chin CC, Yeh CY, Huang WS, et al.Clinical outcome of intersphincteric resection for ultra-low rectal cancer[J].World J Gastroenterol, 2006, 12(4):640-643.
13.	Konanz J, Herrle F, Weiss C, et al.Quality of life of patients after low anterior, intersphincteric, and abdominoperineal resection for rectal cancer-a matched-pair analysis[J].Int J Colorectal Dis, 2013, 28(5):679-688.
14.	Nesbakken A, Nygaard K, Lunde OC.Outcome and late functional results after anastomotic leakage following mesorectal excision for rectal cancer[J].Br J Surg, 2001, 88(3):400-404.
15.	郑芳,阳川华,汪晓东,等.全直肠系膜切除+经肛门内括约肌切除术治疗超低位直肠癌和直肠肛管癌的近期疗效[J].中国普外基础与临床杂志, 2012, 19(7):753-756.
16.	Wilmore DW, Kehlet H.Management of patients in fast track surgery[J].BMJ, 2001, 322(7284):473-476.
17.	Kehlet H, Wilmore DW.Multimodal strategies to improve surgical outcome[J].Am J Surg, 2002, 183(6):630-641.
18.	刘展,汪晓东,李立.结直肠外科快速流程内容及依据[J].中国普外基础与临床杂志, 2007, 14(4):469-474.
19.	Smith TJ, Hillner BE.Ensuring quality cancer care by the use of clinical practice guidelines and critical pathways[J].J Clin Oncol, 2001, 19(11):2886-2897.
20.	Kehlet H, Wilmore DW.Fast-track surgery[J].Br J Surg, 2005,92(1):3-4.
21.	Starfield B, Shi L, Macinko J.Contribution of primary care to health systems and health[J].Milbank Q, 2005, 83(3):457-502.
22.	Kehlet H.Fast-track colorectal surgery[J].Lancet, 2008, 371(9615):791-793.
23.	傅传刚,从志杰.直肠癌手术临床路径[J].中国实用外科杂志, 2011, 31(2):140-144.
24.	杨东杰,蔡世荣,何裕隆,等.快速康复外科在结直肠癌择期手术中的应用效果[J].中华普通外科杂志, 2009, 24(6):477-481.
25.	王刚,江志伟,鲍扬,等.加速康复外科理念指导116例结直肠癌手术[J].中华胃肠外科杂志, 2010, 13(5):342-345.
26.	Fitzpatrick JM, Wickham JE.Minimally invasive surgery[J].Br J Surg, 1990, 77(7):721-722.
27.	Hamad GG, Curet M.Minimally invasive surgery[J].Am J Surg, 2010, 199(2):263-265.
28.	Jayne DG, Thorpe HC, Copeland J, et al.Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer[J].Br J Surg, 2010, 97(11):1638-1645.
29.	Baik SH, Gincherman M, Mutch MG, et al.Laparoscopic vs.open resection for patients with rectal cancer:comparison of perioperative outcomes and long-term survival[J].Dis Colon Rectum, 2011, 54(1):6-14.
30.	Wang XD, Lv DH, Song H, et al.Multimodal preoperative evaluation system in surgical decision making for rectal cancer:a randomized controlled trial[J].Int J Colorectal Dis, 2010, 25(3):351-358.
31.	Fazio VW, Tekkis PP, Remzi F, et al.Assessment of operative risk in colorectal cancer surgery:the Cleveland Clinic Foundation colorectal cancer model[J].Dis Colon Rectum, 2004, 47(12):2015-2024.
32.	Morris EJ, Taylor EF, Thomas JD, et al.Thirty-day postoperative mortality after colorectal cancer surgery in England[J].Gut, 2011, 60(6):806-813.
33.	Copeland GP, Jones D, Walters M, et al.POSSUM:a scoring system for surgical audit[J].Br J Surg, 1991, 78(3):356-360.
34.	Tekkis PP, Prytherch DR, Kocher HM, et al.Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM)[J].Br J Surg, 2004, 91(9):1174-1182.
35.	Tekkis PP, Poloniecki JD, Thompson MR, et al.Operative mortality in colorectal cancer:prospective national study[J].BMJ, 2003, 327(7425):1196-1201.
36.	Haga Y, Ikei S, Ogawa M.Estimation of physiologic ability and surgical stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery[J].Surg Today, 1999, 29(3):219-225.
37.	Teeuwen PH, Bremers AJ, Groenewoud JM, et al.Predictive value of POSSUM and ACPGBI scoring in mortality and morbidity of colorectal resection:a case-control study[J].J Gastrointest Surg, 2011, 15(2):294-303.
38.	曹霖,汪晓东,陈珊珊,等.ACPGBI结直肠癌术后风险评估模型临床应用的初步探索[J].中国普外基础与临床杂志, 2008, 15(9):646-651.
39.	Schaffzin DM, Wong WD.Endorectal ultrasound in the preoperative evaluation of rectal cancer[J].Clin Colorectal Cancer, 2004, 4(2):124-132.
40.	Shihab OC, Taylor F, Salerno G, et al.MRI predictive factors for long-term outcomes of low rectal tumours[J].Ann Surg Oncol, 2011, 18(12):3278-3284.
41.	Huh JW, Oh BR, Kim HR, et al.Preoperative carcinoembryonic antigen level as an independent prognostic factor in potentially curative colon cancer[J].J Surg Oncol, 2010, 101(5):396-400.
42.	Eypasch E, Williams JI, Wood-Dauphinee S, et al.Gastrointestinal quality of life index:development, validation and application of a new instrument[J].Br J Surg, 1995, 82(2):216-222.
43.	Walker KG, Bell SW, Rickard MJ, et al.Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer[J].Ann Surg, 2004, 240(2):255-259.
44.	Emmertsen KJ, Laurberg S.Low anterior resection syndrome score:development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer[J].Ann Surg, 2012, 255(5):922-928.
45.	Lange MM, van de Velde CJ.Urinary and sexual dysfunction after rectal cancer treatment[J].Nat Rev Urol, 2011, 8(1):51-57.
46.	吕东昊,汪晓东,阳川华,等.结直肠肿瘤多学科协作诊治模式的数据库初期建设现状[J].中国普外基础与临床杂志, 2007, 14(6):713-715.
47.	余江,卿三华,黄祥成,等.大肠癌Access数据库的建立及其应用[J].第一军医大学学报, 2003, 23(1):78-79.
48.	Rogers EM.Informatization, globalization, and privatization in the new millennium[J].Asian J Commu, 2000, 10(2):71-92.
49.	Sackett DL, Rosenberg WM, Gray JA, et al.Evidence based medicine:what it is and what it isn't.1996[J].BMJ, 1996, 312(7023):71-72.
50.	Horn SD, Gassaway J.Practice-based evidence study design for comparative effectiveness research[J].Med Care, 2007, 45(10 Suppl 2):S50-S57.
51.	Bogatin D.Google CEO’s new paradigm:cloud computing and advertising go hand-in-hand[EB/OL].2006-08-23.http://www.zdnet.com/blog/micro-markets/google-ceos-new-paradigm-cloudcomputing-and-advertising-go-hand-in-hand/369.
52.	Lohr S.The age of big data[N].The N Y Times.2012-02-12.http://www.nytimes.com/2012/02/12/sunday-review/big-datasimpact-in-the-world.html?pagewanted=all.
53.	Schonberger VM, Cukier K.Big data[M].New York:Houghton Mifflin Harcourt Publishing Company, 2009:22-26.
54.	须晋,赵娜.在医院信息化建设中电子病历系统的应用分析[J].华西医学, 2009, 24(4):962-965.
55.	McKay GD, Morgan MJ, Wong SK, et al.Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service:a multicenter study[J].Dis Colon Rectum, 2012, 55(1):42-50.

1. US Cancer Statistics Working Group.United States Cancer Statistics (USCS):1999-2008 incidence and mortality data[R].Atlanta:Department of Health and Human Services, CDC, National Cancer Institute, 2010:11-13.
2. Thomas RM, Sobin LH.Gastrointestinal cancer[J].Cancer, 1995, 75(1 Suppl):154-170.
3. 郑树.我国大肠癌防治研究的挑战与机遇[J].浙江大学学报:医学版, 2004, 33(5):375-378.
4. 汪建平.中国结直肠癌治疗现状——进步与局限并存[J].中华胃肠外科杂志, 2012, 15(10):989-992.
5. 张苏展.大肠癌科普防治手册[EB/OL].2011-06-07.http://www.cacacrc.org.cn/plus/list.php?tid=9&TotalResult=32&PageNo=1.
6. 李立,汪晓东,舒晔,等.四川大学华西医院·结直肠癌手术治疗指南(一)[J].中国普外基础与临床杂志, 2008, 15(10):778.
7. 陈琼,刘志才,程兰平,等.2003~2007年中国结直肠癌发病与死亡分析[J].中国肿瘤, 2012, 21(3):179-182.
8. 张静,马小琴.大肠癌患者的心理一致感、社会支持及生活质量的研究进展[J].解放军护理杂志, 2013, 30(8):39-41.
9. Heald RJ, Husband EM, Ryall RD.The mesorectum in rectal cancer surgery-the clue to pelvic recurrence?[J].Br J Surg, 1982, 69(10):613-616.
10. Schiessel R, Karner-Hanusch J, Herbst F, et al.Intersphincteric resection for low rectal tumours[J].Br J Surg, 1994, 81(9):1376-1378.
11. Maurer CA, Renzulli P, Kull C, et al.The impact of the introduction of total mesorectal excision on local recurrence rate and survival in rectal cancer:long-term results[J].Ann Surg Oncol, 2011, 18(7):1899-1906.
12. Chin CC, Yeh CY, Huang WS, et al.Clinical outcome of intersphincteric resection for ultra-low rectal cancer[J].World J Gastroenterol, 2006, 12(4):640-643.
13. Konanz J, Herrle F, Weiss C, et al.Quality of life of patients after low anterior, intersphincteric, and abdominoperineal resection for rectal cancer-a matched-pair analysis[J].Int J Colorectal Dis, 2013, 28(5):679-688.
14. Nesbakken A, Nygaard K, Lunde OC.Outcome and late functional results after anastomotic leakage following mesorectal excision for rectal cancer[J].Br J Surg, 2001, 88(3):400-404.
15. 郑芳,阳川华,汪晓东,等.全直肠系膜切除+经肛门内括约肌切除术治疗超低位直肠癌和直肠肛管癌的近期疗效[J].中国普外基础与临床杂志, 2012, 19(7):753-756.
16. Wilmore DW, Kehlet H.Management of patients in fast track surgery[J].BMJ, 2001, 322(7284):473-476.
17. Kehlet H, Wilmore DW.Multimodal strategies to improve surgical outcome[J].Am J Surg, 2002, 183(6):630-641.
18. 刘展,汪晓东,李立.结直肠外科快速流程内容及依据[J].中国普外基础与临床杂志, 2007, 14(4):469-474.
19. Smith TJ, Hillner BE.Ensuring quality cancer care by the use of clinical practice guidelines and critical pathways[J].J Clin Oncol, 2001, 19(11):2886-2897.
20. Kehlet H, Wilmore DW.Fast-track surgery[J].Br J Surg, 2005,92(1):3-4.
21. Starfield B, Shi L, Macinko J.Contribution of primary care to health systems and health[J].Milbank Q, 2005, 83(3):457-502.
22. Kehlet H.Fast-track colorectal surgery[J].Lancet, 2008, 371(9615):791-793.
23. 傅传刚,从志杰.直肠癌手术临床路径[J].中国实用外科杂志, 2011, 31(2):140-144.
24. 杨东杰,蔡世荣,何裕隆,等.快速康复外科在结直肠癌择期手术中的应用效果[J].中华普通外科杂志, 2009, 24(6):477-481.
25. 王刚,江志伟,鲍扬,等.加速康复外科理念指导116例结直肠癌手术[J].中华胃肠外科杂志, 2010, 13(5):342-345.
26. Fitzpatrick JM, Wickham JE.Minimally invasive surgery[J].Br J Surg, 1990, 77(7):721-722.
27. Hamad GG, Curet M.Minimally invasive surgery[J].Am J Surg, 2010, 199(2):263-265.
28. Jayne DG, Thorpe HC, Copeland J, et al.Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer[J].Br J Surg, 2010, 97(11):1638-1645.
29. Baik SH, Gincherman M, Mutch MG, et al.Laparoscopic vs.open resection for patients with rectal cancer:comparison of perioperative outcomes and long-term survival[J].Dis Colon Rectum, 2011, 54(1):6-14.
30. Wang XD, Lv DH, Song H, et al.Multimodal preoperative evaluation system in surgical decision making for rectal cancer:a randomized controlled trial[J].Int J Colorectal Dis, 2010, 25(3):351-358.
31. Fazio VW, Tekkis PP, Remzi F, et al.Assessment of operative risk in colorectal cancer surgery:the Cleveland Clinic Foundation colorectal cancer model[J].Dis Colon Rectum, 2004, 47(12):2015-2024.
32. Morris EJ, Taylor EF, Thomas JD, et al.Thirty-day postoperative mortality after colorectal cancer surgery in England[J].Gut, 2011, 60(6):806-813.
33. Copeland GP, Jones D, Walters M, et al.POSSUM:a scoring system for surgical audit[J].Br J Surg, 1991, 78(3):356-360.
34. Tekkis PP, Prytherch DR, Kocher HM, et al.Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM)[J].Br J Surg, 2004, 91(9):1174-1182.
35. Tekkis PP, Poloniecki JD, Thompson MR, et al.Operative mortality in colorectal cancer:prospective national study[J].BMJ, 2003, 327(7425):1196-1201.
36. Haga Y, Ikei S, Ogawa M.Estimation of physiologic ability and surgical stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery[J].Surg Today, 1999, 29(3):219-225.
37. Teeuwen PH, Bremers AJ, Groenewoud JM, et al.Predictive value of POSSUM and ACPGBI scoring in mortality and morbidity of colorectal resection:a case-control study[J].J Gastrointest Surg, 2011, 15(2):294-303.
38. 曹霖,汪晓东,陈珊珊,等.ACPGBI结直肠癌术后风险评估模型临床应用的初步探索[J].中国普外基础与临床杂志, 2008, 15(9):646-651.
39. Schaffzin DM, Wong WD.Endorectal ultrasound in the preoperative evaluation of rectal cancer[J].Clin Colorectal Cancer, 2004, 4(2):124-132.
40. Shihab OC, Taylor F, Salerno G, et al.MRI predictive factors for long-term outcomes of low rectal tumours[J].Ann Surg Oncol, 2011, 18(12):3278-3284.
41. Huh JW, Oh BR, Kim HR, et al.Preoperative carcinoembryonic antigen level as an independent prognostic factor in potentially curative colon cancer[J].J Surg Oncol, 2010, 101(5):396-400.
42. Eypasch E, Williams JI, Wood-Dauphinee S, et al.Gastrointestinal quality of life index:development, validation and application of a new instrument[J].Br J Surg, 1995, 82(2):216-222.
43. Walker KG, Bell SW, Rickard MJ, et al.Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer[J].Ann Surg, 2004, 240(2):255-259.
44. Emmertsen KJ, Laurberg S.Low anterior resection syndrome score:development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer[J].Ann Surg, 2012, 255(5):922-928.
45. Lange MM, van de Velde CJ.Urinary and sexual dysfunction after rectal cancer treatment[J].Nat Rev Urol, 2011, 8(1):51-57.
46. 吕东昊,汪晓东,阳川华,等.结直肠肿瘤多学科协作诊治模式的数据库初期建设现状[J].中国普外基础与临床杂志, 2007, 14(6):713-715.
47. 余江,卿三华,黄祥成,等.大肠癌Access数据库的建立及其应用[J].第一军医大学学报, 2003, 23(1):78-79.
48. Rogers EM.Informatization, globalization, and privatization in the new millennium[J].Asian J Commu, 2000, 10(2):71-92.
49. Sackett DL, Rosenberg WM, Gray JA, et al.Evidence based medicine:what it is and what it isn't.1996[J].BMJ, 1996, 312(7023):71-72.
50. Horn SD, Gassaway J.Practice-based evidence study design for comparative effectiveness research[J].Med Care, 2007, 45(10 Suppl 2):S50-S57.
51. Bogatin D.Google CEO’s new paradigm:cloud computing and advertising go hand-in-hand[EB/OL].2006-08-23.http://www.zdnet.com/blog/micro-markets/google-ceos-new-paradigm-cloudcomputing-and-advertising-go-hand-in-hand/369.
52. Lohr S.The age of big data[N].The N Y Times.2012-02-12.http://www.nytimes.com/2012/02/12/sunday-review/big-datasimpact-in-the-world.html?pagewanted=all.
53. Schonberger VM, Cukier K.Big data[M].New York:Houghton Mifflin Harcourt Publishing Company, 2009:22-26.
54. 须晋,赵娜.在医院信息化建设中电子病历系统的应用分析[J].华西医学, 2009, 24(4):962-965.
55. McKay GD, Morgan MJ, Wong SK, et al.Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service:a multicenter study[J].Dis Colon Rectum, 2012, 55(1):42-50.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The New Concepts and Challenges of Surgery for Colorectal Cancer

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