Mr. Zhao, 45 years old this year, recently without obvious inducements to have blood in the stool, while having a feeling of fall and incomplete defecation, went to the local hospital for treatment, colonoscopy and pathological examination, the results showed that he had rectal cancer, and then referred to the Department of Colorectal Tumor Surgery of the Second Affiliated Hospital of Harbin Medical University, and after admission, further imaging examination and tumor marker testing were found to be accompanied by liver metastasis. Under the auspices of Vice President Liu Ming, Professor Huang Rui's team of Colorectal Tumor Surgery recently performed 3D laparoscopic rectal cancer with liver metastasis and natural cavity specimen retrieval (NOSES) surgery for Mr. Zhao through multidisciplinary discussion and evaluation and preoperative development of the best surgical method. So far, Professor Huang Rui's team has completed 7 cases of laparoscopic NOSES for rectal cancer, and all of them have been completely successful, thus winning more hope for patients with advanced colorectal cancer.
According to Professor Huang Rui, specimen retrieval surgery (NOSES) refers to the use of laparoscopy, robots and other equipment to complete the surgical operation in the abdominal cavity, through the mouth, vagina, anus and other natural cavity of the human body to remove the specimen (lesion), the abdominal wall without any auxiliary incision, after the operation only a few tiny poke card scars remain in the abdomen, can be called a minimally invasive, no scarring, and even "minimally invasive in the minimally invasive" surgical method. NOSES technology is considered to be the third generation of minimally invasive technology after laparoscopy, compared with traditional open abdominal and laparoscopic surgery, the former is less traumatic, postoperative recovery time is shorter, and helps to reduce intraoperative and postoperative pain, avoid incision infection, incisional hernia and chronic abdominal wall pain, reduce postoperative abdominal adhesions and adhesions and other complications, thereby accelerating the recovery process of patients.
During the simultaneous resection of NOSES for laparoscopic rectal cancer and liver metastases for Mr. Zhao, the advantages and characteristics of this combination of minimally invasive surgery were demonstrated. The 3-hour operation was very smooth, the patient did not have any auxiliary incision in the abdomen, the liver metastases and rectal lesions were removed from the body through the rectal anus, and the amount of bleeding was only about 20 ml. After the operation, Mr. Zhao recovered very quickly, went to the ground the next day, began to eat liquid food on the third day, and was cured and discharged from the hospital one week after the operation. Professor Huang Rui commented that in the past, resection of liver metastasis of rectal cancer often required a large incision of about 20 cm in the upper and lower abdomen, and traditional laparoscopic surgery also had an auxiliary incision of about 8 cm long for specimen retrieval. The NOSES technique used this time leaves only a few one-cent coin-sized pokes on the abdominal wall. Professor Huang also said that colorectal cancer patients should not ignore the importance of intraoperative exploration because of detailed imaging examination before surgery, and must pay attention to close inspection of abdominal organs during surgery so as not to miss other lesions.
Vice President Liu Ming commented that if colorectal cancer and liver metastases can be removed at the same time, the 5-year survival rate can reach 30-40%; while the liver metastasis cannot be resected, the 5-year survival rate is only 1-2%, so early detection of liver metastases and grasping radical resection is the most effective way to improve the prognosis of colorectal cancer liver metastases. The NOSES surgery is to ensure the radical treatment of the tumor, ideally solve a series of postoperative related problems caused by abdominal incisions, so that patients can obtain better minimally invasive efficacy and clinical benefits. Vice President Liu Ming also suggested that colorectal cancer with liver metastasis cases should adhere to multidisciplinary discussion and choose the best diagnosis and treatment plan, thereby improving the clinical effect of colorectal cancer liver metastasis.
So far, the Department of Colorectal Tumor Surgery of the Second Hospital of Harbin Medical University has completed 7 cases of 3D laparoscopic colorectal cancer with liver metastasis and NOSES surgery at the same time, accumulating certain experience, marking that the minimally invasive technique of colorectal tumor surgery has ranked first in China. Minimally invasive has always been the development direction of surgical methods, as early as 2010, the hospital's colorectal tumor surgery under the leadership of Professor Wang Xishan, a famous bowel cancer expert in China, completed the world's first case of natural pore rectal cancer radical resection (NOTES), and led the team to create a series of natural cavity specimen collection surgery (NOSES surgery). As the birthplace of NOSES surgery, the Department of Colorectal Tumor Surgery of the Second Hospital of Harbin Medical University has participated in the preparation of many monographs and the formulation of the consensus of NOSES surgery experts at home and abroad, and has carried out more than 500 NOSES surgeries. In terms of minimally invasive surgery for colorectal tumors, it has always been at the forefront of the country.
Profile of Vice President Liu Ming
Vice President of the Second Affiliated Hospital of Harbin Medical University, Doctoral Supervisor, Professor.
He is good at radical surgery and comprehensive treatment of gastric cancer and colorectal cancer, and is committed to the chemoprevention and proteomics research of malignant tumors, and has established a proteomics model of colorectal cancer in the north.
Profile of Chief Physician Huang Rui
Department of Colorectal Tumor Surgery, Second Affiliated Hospital of Harbin Medical University (Ninth Ward of General Surgery)
Chief Physician, MD, Postdoctoral Fellow, Master Supervisor.
Actively carry out minimally invasive treatment of gastrointestinal tumors, and master the open abdominal radical resection of colorectal cancer, the da Vinci robotic surgery of colorectal cancer, the full laparoscopic surgery, the TEM surgery of rectal cancer, and the radical nosES surgery of colorectal cancer taken from the natural cavity. Advocating the concept of multidisciplinary comprehensive treatment has greatly improved the treatment effect and survival rate of colorectal tumor patients.