The Department of Colorectal Surgery was established in 2009, which used to be part of the Department of Abdominal Surgery. Under the leadership of Professor Desen Wan and Director Zhizhong Pan, the whole department has made remarkable achievements with concerted efforts.
The department now has two sections, 70 beds, an ostomy treatment room, an anorectal manometry room and a research laboratory. At present, it has become one of the largest and most influential medical centers for colorectal cancer in China. The titles of the department are listed as below:
The colorectal cancer training center of the Chinese Anti-cancer Association
The national demonstration unit of the colorectal cancer multidisciplinary team (MDT)
The training center of laparoscopic surgeons of the Chinese Medical Doctor Association
The national training center of enterostomal therapist (ET) nurses
The central unit of colorectal cancer registration (follow-up) in South China
The key clinical specialty of Guangdong Province
The department mainly focuses on colorectal tumors as well as gastrointestinal stromal tumors (GIST) and neuroendocrine tumors (NET). The features of medical care in the department are as follows:
1. Precision medicine based on MDT
The multidisciplinary team (MDT) started in 1998, and has been recommended and extensively used in daily clinical practice. Prof. Desen Wan held the position of chief-specialist and leader of the MDT for colorectal cancer. Relying on the cooperation of comprehensive specialties, every patient receives reasonable and optimal treatments according to TNM stage, and tumor biological characteristics. Summarizing all colorectal cancer cases data treated in the department, the 5-year survival rate is 66.3% and postoperative local recurrence is only 6%-8%, which represents the leading level around the country.
2. Minimally invasive surgery
The department was one of the first oncology centers in China to carry out minimally invasive surgeries of colorectal cancer.In 2019, the department carried out 1,959 operations, including more than 1,600 laparoscopic surgeries. While emphasizing standardized treatment, the department tried its best to provide minimally invasive treatment for patients to alleviate their pain and promote postoperative rehabilitation.The laparoscopy course organized by the department has transmitted the concepts of "standardization" and "minimally invasive" to every student through close teaching and interactive communication, which has become a brand academic activity to promote the advanced level of colorectal cancer treatment at SYSUCC.
3. Comprehensive treatment for Liver metastasis
In order to prevent liver metastases from colorectal cancer after surgery, several methods have been undertaken in the department, including 5-FU based intraoperative chemotherapy (intra-luminal, intra-portal vein, intra-abdominal), postoperative intra-portal vein 5-FU continuous infusion and 5-FU based sustained-release implantation. Regarding the management of CRC liver metastasis, the department has accumulated rich experience, relying on surgical resection, accompanied with chemotherapy and local ablation. These measures significantly improved 5-year survival rates. Particularly, for CRC patients with unresectable liver metastasis, selected cases with good response and significant tumor shrinkage after chemotherapy were provided the option of liver resection. This treatment strategy leads to encouraging results. In order to promote development in this field, the CRC Liver Metastasis Group of China Anti-cancer Association was set up, and Prof. Zhizhong Pan, the current director of the department, has been selected as chairman of the group.
4. Perioperative treatment for rectal cancer
Based on the standard treatment (preoperative neoadjuvant therapy, radical surgery and postoperative adjuvant therapy), the department conducted several clinical trials, such as preoperative chemotherapy alone vs. preoperative radiaochemotherapy, enhanced preoperative radiaochemotherapy for locally advanced rectal cancer, et al. For patients benefiting from optimized perioperative treatment strategies, defecation, urination and sexual function are preserved as much as possible on the basis of achieving radical treatment.
The department also provides TEM (transanal endoscopic microsurgery). A technique for small or benign tumors/polyps arising in the lower part of rectum, which provides more opportunities for sphincter-sparing and better quality of life after surgery.
5. Screening and management of hereditary colorectal cancer
Since 2011, SYSUCC began conducting MMR immunohistochemical testing and Lynch syndrome screening for all newly diagnosed colorectal cancer patients. The working group on hereditary colorectal cancer was set up in 2014, which was composed of relevant medical staff from the departments of colorectal cancer, pathology, molecular diagnostics and endoscopy. In 2015, the first consultation clinic for genetic colorectal cancer in China was officially established in the department. So far, more than 10,000 colorectal cancer patients have received genetic screening, and nearly 300 genetic families are under follow-up management.
6. GIST and NET
The department is the leading unit of the cooperation group of GIST in South China, with a detailed diagnosis and treatment database. At the same time, the hospital has set up a multidisciplinary consultation platform for neuroendocrine tumors.
7. Stoma care and rehabilitation
Stoma therapy and rehabilitation is another specialized nursing program within the department, which provides better care for those with an ostomy. The department estabilshed the first enterostomal therapists (ET) school in China to train internationally certified ET nurses. The department is currently the most important ET nurse training base in China.
8. Society screening
Prof. Desen Wan conducted one of the earliest colorectal cancer screening programs in China. From the continuous efforts of the department, the program has gained the support and funds from the health commission, which provides screening services including free lectures and counseling, fecal occult blood testing and colonoscopies to various communities. As a result, dozens of CRC patients have been identified from the population every year.
The department takes responsibility for different levels of teaching tasks, including undergraduates, postgraduates, and CME (continuous medicine education) courses. It is also a base for postgraduate master and Ph.D. students. There are 6 professors who hold the title of Ph.D. supervisor, and another 6 surgeons hold the title of Master's supervisor. Since 2009, there are 13 Ph.D. and 11 master students who have graduated from the department.
Clinical Oncology (1st to 5th Ed.) edited by Prof. Desen Wan is taken as textbook for Chinese medical students.
The ET nurse training program has been awarded an excellent teaching tool by the university since 2008.
Research and Academic Activities
The faculty has always attached great importance to scientific research. As a clinical faculty of Sun Yat-Sen University, CRC places great effort upon basic and continued medical education and training, emphasizing upon basic principles, methodology training, individual independence. In the surgical lab located on the 7th floor, there is a full-time and professional research scientist, and a technician. There are more than 10 ongoing research programs, including projects funded by the National Key R&D Program, the National Natural Science Foundation of China, the Science and Technology Planning Projects of Guangzhou and so on.
In 2010, the research 《community prevention and comprehensive treatment of colorectal cancer》 won second prize at the Science and Technology Award of the China Anti-cancer Association. In 2015, the research 《individualized treatment of colorectal cancer》won first prize at the China Medical Science and Technology Awards.
The department has kept close connection with the Mayo Clinic and Memorial Sloan-Kettering Cancer Centers in the USA, Adelaide University in Australia, Paul Brousse Hospital in France, and institutions in Hong Kong. Several surgeons of the department have studied in the above institutes.
The department regularly holds academic conferences and training courses, including:
T he Annual Meeting of Colorectal cancer association of Guangdong Province. This series of meetings began in 1999. It has become the most important and significant one in Guangdong province, with about 500 professional delegates attending each meeting.
The Annual National ET training course began in 1998 and the Annual Sun Yat-sen University ET School course started 2001. The CME course has trained over 1,000 professional nurses in providing primary ET nursing. The school has trained more than 399 internationally certified ET nurses. It is currently the most important ET nurse training base in China.