ObjectiveTo describe the constructive process of follow-up of colorectal cancer part in the Database from Colorectal Cancer (DACCA) in West China Hospital. MethodThe article was described in words. ResultsThe specific concepts of follow-up of colorectal cancer including end-stage of follow-up, survival status, follow-up strategy, follow-up emphasis, follow-up plan, follow-up record using communication tools, follow-up frequency, annual follow-up times, and single follow-up record of the DACCA in the West China Hospital were defined. Then they were detailed for their definition, label, structure, error correction, and update. ConclusionThrough the detailed description of the details of follow-up of colorectal cancer of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
3.2 腹腔镜左半结肠切除术3.2.1 手术要点 腹腔镜左半结肠切除术的要求往往高过腹腔镜右半结肠切除术,所以,除一套腹腔镜器械外,还应增备一套开腹手术器械,一旦腹腔镜手术中出现难以控制的出血以及必须开腹处理的特殊情况,应毫不犹豫中转开腹手术。......
ObjectiveTo summarizes the mechanisms of carcinogenesis of colorectal cells, the occurrence and development of cancer cells, and their interactions with the tumor niche of colorectal cancer (CRC) from the perspective of the tumor niche, exploring new ideas for the prevention, diagnosis, and treatment of CRC. MethodThe relevant literature at home and abroad in recent years on the researches of mechanism of the occurrence and development of CRC and its relation with the tumor niche of CRC was searched and reviewed. ResultsThe theory of tumor ecology indicates that the human normal body can be regarded as a relatively closed and perfect ecosystem. Each normal tissue and organ within the body represent a niche in this ecosystem, which interact, affect, and symbiotically coexist with each other, forming a dynamic ecological balance. Tumor cells, being a “new species” distinct from normal tissue cells, “invade” the ecological system of the normal body under specific conditions and interact with the surrounding microenvironment, which is defined as the tumor niche. Analysis of current literature retrieved from the perspective of the tumor niche suggested that, although genetic factors are involved in the carcinogenesis of colorectal cells, the majority of such carcinogenesis stems from the continuous stimulation of the colorectal niche. Current research primarily focuses on the conclusion that the carcinogenesis of colorectal cells is associated with factors such as chronic inflammatory response, intestinal microorganisms, oxidative stress, and pyroptosis. After carcinogenesis and the eventual formation of CRC, the growth of cancer cells and tissues first requires breaching the defense of the immune system in the colorectal niche. Immune cells in the immune system play a crucial role in the tumor niche during the occurrence and development of CRC. ConclusionsThe proposal of the tumor niche concept enables researchers, when studying the mechanisms of tumor occurrence and development, to no longer merely focus on the tumor and its microenvironment. Instead, the tumor as a part of the body’s ecosystem was studied. Components of the tumor niche, such as chronic inflammatory responses, intestinal microorganisms, oxidative stress, pyroptosis, and immune system, have a significant impact on the mechanisms of carcinogenesis of most colorectal cells, as well as the occurrence and development of cancer cells. These factors influence the progression of CRC in various aspects.
目的 探讨直肠癌前切除术吻合口漏的原因及对策。方法 对符合行直肠前切除术的73例直肠癌患者行全直肠系膜切除术,用双吻合器技术(double-stapling technique,DST)吻合结直肠。2004年1月以后收治的病例特别注意了会阴助推、 远侧直肠密闭试验、吻合器穿刺头穿刺点的选择、吻合口漏气试验和经肛门至结肠及经腹壁至吻合口旁放置引流管的技术细节。结果 全组2例(2.74%)发生吻合口漏,均为2004年1月以前的病例,1例经横结肠造瘘治愈,另1例经引流管冲洗治疗治愈; 2004年1月以后的65例无吻合口漏发生。结论 注意直肠癌前切除术中的一些技术细节, 可在一定程度上降低全直肠系膜切除条件下DST吻合的吻合口漏发生率。