Objective To explore application of preoperative examination in the colorectal cancer patients. Methods The preoperative examination data of patients diagnosed definitely as colorectal cancer at West China Hospital of Sichuan University from November 2006 to June 2007 was retrospectively study, and the application situation and relationship among all preoperative examination in the colorectal cancer patients were analyzed. Results According to the inclusion criteria, 438 colorectal cancer patients were included which involved 260 males and 178 females. Preoperative examinations included two to sixteen items, with an average of 10.61 items. According to correlation analysis, positive correlation existed among lung function and blood type ( r =0.161, P =0.001), tumor marker ( r =0.118, P =0.014), chest X-ray ( r =0.113, P =0.018), routine electrocardiogram ( r =0.198, P =0.000) , while lung function and immune and stress reaction exhibit a negative correlation ( r =-0.106, P = 0.027) with preoperative examinations. At the same time, immune and stress reaction had positive correlation to CT examinations of abdomen ( r =0.151, P =0.001) as well as endorectal ultrasound ( r =0.330, P =0.000). Using univariate analysis, the influence of tumor location ( P =0.012) and operative method ( P =0.004) on the number of examination items was significant. Conclusion Preoperative examination of colorectal tumor surgery mainly includes routine examination, neoplasm-related examination and important organs function detection. And three levels of preoperative menu can be set up in early stage. Establishment of normalization preoperative combined examination may be helpful to consummate preoperative evaluation and improve medical quality.
Objective To compare the clinical effect between neo-adjuvant chemotherapy combined with operation and simple operation under multi-disciplinary team in rectal cancer. Methods A survey of 72 patients with rectal cancer from Nov. 2007 to Mar. 2008 were studied. Patients were divided into two groups using a simple random method: 33 cases in combined therapy group were treated with single period neo-adjuvant chemotherapy as well as operation and 39 cases in control group received operation only. To compare the differences of perioperative period indexes between two groups. Results During the differences of indexes of age, gender, differentiation degree, clinicopathologic stage as well as the distance to dentate line of tumor, there was no statistical significance between combined therapy group and control group (Pgt;0.05). And at the same time, the operative type, operative time and bleeding quantity in operation had no statistically significant difference between two groups (Pgt;0.05). As for the postoperative rehabilitation indexes, the time of vent to normal in combined therapy group was earlier than that in control group, but the intake time was later than that in control group （Plt;0.05）. Falling range from preoperative CEA to postoperative CEA was larger in combined therapy group than that in control group （Plt;0.05）; and the falling range from preoperative WBC to postoperative WBC had no significant difference between two groups （Pgt;0.05）. Conclusion The clinical effect of combined therapy is obviously superior to simple operation, suggesting that neo-adjuvant chemotherapy combined with operation is feasible and safe.
Objective To discuss the performance of multi-disciplinary team (MDT) of colorectal cancer treatment within West China Hospital in Sichuan University. Methods To compare the therapeutic effect between groups of MDT model and non-MDT model by retrospectively analyzing the data of patients who diagnosed colorectal cancer and accepted in-hospital therapy during December 2006 and May 2007. Results The in-hospital days of the MDT model group during the perioperative period and in the surgical ward were less than that of the non-MDT model group ( Plt; 0. 05) , but there was no significant difference between the two groups about the total hospitalization time. And the MDT model group had a higher rate of cancer resection ( P lt; 0. 05) . Although the incidence of anastomotic leakage and bleeding as early postoperative complications didn’t show any variations between the two groups , the non-MDT model groupencountered more early postoperative ileus ( Plt; 0. 05) . During the 5－ 10 months follow-up , there came out less cancer recurrence rate in the MDT model group than the other ( P lt; 0. 05) . And the morbidity of anastomotic stricture and ileus didn’t show any statistical difference between the two groups. Conclusion The combined-therapy st rategy ofcolorectal cancer has showed a priority to routine ways , not only the more reasonable time arrangement for therapy , but also the more satisfied surgical outcomes. However , the factors correlated to the efficacy of the MDT model are not clear ; the MDT model still needs to be improved that a morereasonable and effective perioperative MDT model may come t rue.
Objective To build a systematic, comprehensive, high efficient and maneuverable follow-up system in multi-disciplinary team (MDT). Methods Comparing with abroad follow-up practical management, the advantages and disadvantages were analyzed by using multiple follow-up forms and the construct of staffs to guide and evaluate the postoperative patients in colorectal carcinoma at the beginning of follow up system. Results Follow-up system was made rationalized, and an effective follow-up model was built up to extend in MDT. Conclusion Following up the present situation with patients of colorectal cancer in this country, the correct direction which is based on current follow-up system would be put out. That would be the important study to improve the medical treatment in next stage.
Objective To analyze the primary status of database in multi-disciplinary team （MDT） of colorectal cancer, and to explore the tendency in construction of database in the future. Methods Described the current status of different database respectively, and analyzed the data statistically, involving the patients’ general information, essential information of duration of hospital stay, therapy and MDT from the database of patients. Results The development of different database was uncoordinated. Among the total, the database of patients was advanced, the database of reference and the database of specialists were also developing in certain. Conclusion The primary reason, which results in the lag of construction of database currently, is the long span of database and the cost of much time in data acquisition. The direction of development of database involves consummation of database gradually, refreshment of it promptly, and expanding the research of informatics related clinical medicine.
Objective To explore the modality of multi-disciplinary team (MDT) applied in surgical treatment of the colorectal cancer. Methods The literatures about the applied status and opinion of the modality applied in the surgical treatment of colorectal cancer in recent years were collected and reviewed. Results The modality of MDT in surgical treatment of the colorectal cancer is still in the primary stage. Conclusion There are lots of problem of this modality such as construction and collaborative needed more research.
Cancer TNM staging; Esophageal carcinoma; Worldwide collaboration
Cochrane协作网（www.cochrane.org）是世界上最大的致力于制作、保存和提升卫生保健干预效果系统评价可及性的国际组织。它拥有100多个参与国，主要与负责制作和保存Cochrane系统评价的各Cochrane系统评价组相关。从2000年起，依靠散在各国的各Cochrane系统评价组活跃成员已完成系统评价的定期审核。至2010年初，协作网已从2000年约5 500人增加至近28 000人。Cochrane活动发展迅速，Cochrane系统评价和计划书的作者人数增长尤为突出。2000年，各Cochrane系统评价组有2 840个注册作者。到2010年初，注册作者数已升至21 000人以上。
The Campbell collaboration (C2) is an international research network that produces and disseminates systematic reviews of the effects of interventions in education, criminal justice, and social welfare. It aims to generate the best research evidence to support policy and practice in order to bring about positive social change. This issue introduces the experiences of the author while taking part in the ninth annual Campbell colloquium, and tries to increase awareness about C2.