1.Characteristics and outcomes of patients with colorectal cancer who underwent laparoscopic colorectal surgery: Descriptive study.
Kim Recoli S. delos Reyes ; Orlando F. Basilio Jr.
Southern Philippines Medical Center Journal of Health Care Services 2025;11(2):1-6
BACKGROUND
Laparoscopic surgery is a widely accepted treatment modality, but with few disadvantages.
OBJECTIVETo describe the demographic, clinical, tumor, and operative characteristics of patients with colorectal cancer who underwent laparoscopic surgery.
DESIGNDescriptive study.
PARTICIPANTS47 males and 40 females, aged 19 years and older with colorectal cancer who underwent laparoscopic colorectal surgery.
SETTINGSurgery Department - Colorectal Surgery section, Southern Philippines Medical Center, Davao City, August 2014 to August 2018.
MAIN OUTCOME MEASURESDemographic and clinical characteristics, tumor profile, and operative outcomes.
MAIN RESULTSThis study analyzed 87 patients with colorectal cancer who underwent laparoscopic colorectal surgery. The participants had a mean age of 56.55 ± 11.99 years, with a slight male predominance (54.02%). Most patients resided within Davao Province (72.41%) and commonly presented with comorbidities, particularly hypertension (22.99%). Tumors were mostly located in the rectum (62.07%), and the majority of patients had advanced disease, with 59.77% classified as stage IIIB. Advanced tumor invasion was common, with 60.92% of patients presenting with T3 and 32.18% with T4 disease, while lymph node involvement was observed in 75.86% of cases. Distant metastasis was present in 11.49% of patients, most frequently involving the liver. Low anterior resection was the most commonly performed procedure (39.08%). The mean operative time was 278.89 ± 72.76 minutes, with a mean blood loss of 476.73 ± 341.86 mL and a conversion-to-open rate of 23.26%. Postoperative outcomes showed a morbidity rate of 26.44% and a mortality rate of 3.45%, with patients resuming oral intake after a mean of 4.02 ± 2.17 days and a mean hospital stay of 8.35 ± 6.38 days.
CONCLUSIONLaparoscopic colorectal surgery at our institution was performed among middle-aged patients, mostly males. Rectal cancer was the most common diagnosis, with most patients presenting with advanced stage IIIB disease, and low anterior resection was the most frequently performed procedure. The mean operative time was 279 minutes, with a conversion-to-open rate of nearly 25%. The mean intraoperative blood loss was 476 mL. Oral intake was resumed after a mean of 4 days. The mean hospital stay was 8 days, with low mortality despite a moderate morbidity rate.
Human ; Minimally Invasive Surgery ; Minimally Invasive Surgical Procedures ; Tumor ; Neoplasms ; Mortality
2.The supraclavicular artery island flap: A practical approach for reconstruction of extensive cervicofacial defects following giant cavernous hemangioma resection
Heather Grace P. Dulnuan ; Anna Claudine F. Lahoz ; Arsenio Claro A. Cabungcal
Philippine Journal of Otolaryngology Head and Neck Surgery 2025;40(Supplement):45-49
OBJECTIVES
o demonstrate the utility of the supraclavicular artery island flap (SCAIF) as a viable alternative to free tissue transfer for reconstruction of large cervicofacial defects.
METHODSDesign:Case Report
Setting:Tertiary National University Hospital
Patient: One
RESULTSA 43-year-old woman with a giant cavernous hemangioma measuring 21.43 x 9.91 x 20.75cm underwent tumor resection and immediate reconstruction using SCAIF. Following preoperative embolization and complete tumor excision, an 11 x 15cm cervicofacial defect was successfully reconstructed using SCAIF. The patient experienced post-operative complications including multiple wound dehiscences and hypertrophic scar formation but achieved significant functional and aesthetic improvement. At three months follow up, the patient reported cessation of bleeding episodes, improved feeding capacity, and enhanced quality of life despite persistent tracheostomy dependence. Plans for secondary surgery include scar revision, commissuroplasty, and intralesional steroid injections.
CONCLUSIONThe supraclavicular artery island flap presents a practical, cost-effective alternative to free tissue transfer for extensive cervicofacial reconstruction, particularly in resource-limited environments or in patients where free tissue transfer is contraindicated. Advantages include good color match, wide arc of rotation, and ease of harvest. Despite potential complications, it offers excellent functional and aesthetic outcomes with acceptable donor site morbidity.
Human ; Female ; Young Adult: 19-24 Yrs Old ; Aids-related Complex ; Neoplasms ; Costs And Cost Analysis ; General Surgery ; Environment ; Research Report ; Steroids ; Tracheostomy ; Hospitals
3.Breaking barriers in robotic surgery: Efficiency and safety of a low-cost, single-port extraperitoneal robotic-assisted radical prostatectomy
Rajiv H. Kalbit ; Enrique Ian S. Lorenzo
Philippine Journal of Urology 2025;35(2):81-87
INTRODUCTION AND OBJECTIVE
The increasing demand for cost-effective surgical techniques has driven innovations in robotic-assisted radical prostatectomy (RARP). While single-port robotic surgery reduces invasiveness and improves cosmesis, its widespread use is limited by high costs and technical constraints. This study evaluates the safety, feasibility and cost-effectiveness of extraperitoneal single-port robotic-assisted radical prostatectomy (espRARP) using a modified Da Vinci Si HD system, employing a wound protector and surgical glove as a low-cost multi-channel laparoscopic port.
METHODSTen patients with localized prostate cancer underwent espRARP using a three-arm Da Vinci Si system and side docking to enhance instrument access. A homemade multi-channel port was constructed using an Alexis® wound protector and surgical gloves. Perioperative outcomes—including operative time, blood loss, complications and oncologic results were analyzed descriptively.
RESULTSAll cases were completed without conversion to open surgery. The mean operative time was 215.8 minutes with an estimated blood loss of 200 mL. No positive surgical margins were recorded, and 20% of patients exhibited pathological upgrading. The average hospital stay was 3.4 days. One patient developed a Clavien–Dindo II complication; no major complications occurred
LIMITATIONSThis pilot study is limited by its small sample size (n = 10), single-surgeon, single institution design, short follow-up period, and absence of functional outcome assessment. Only descriptive analysis was performed without statistical comparison.
CONCLUSIONThe modified espRARP technique using a low-cost glove-port and three-arm Da Vinci Si system is safe, feasible and cost-efficient. Comparable perioperative and oncologic outcomes to conventional multi-port and proprietary single-port systems were achieved at a fraction of the cost. This approach provides a practical and accessible alternative for robotic prostatectomy in resource-limited healthcare settings.
Human ; Prostatectomy ; General Surgery ; Prostatic Neoplasms
4.Diagnosis and treatment of urologic malignancies in the Philippines: A multi-center prospective cohort study (PUMA study)
Rudolfo I. De Guzman ; Bennie Dick C. Catangay ; Norwin T. Uy ; Hermenegildo Jose B. Zialcita ; Jose-vicente T. Prodigalidad
Philippine Journal of Urology 2025;35(2):88-96
OBJECTIVES
To create a pilot urologic malignancy registry using demographic and clinical data of a cohort of patients newly diagnosed to have urologic malignancies in the year 2021.
METHODSThis was a prospective cohort study conducted in four study sites: National Kidney and Transplant Institute, East Avenue Medical Center, UP-Philippine General Hospital and Batangas Medical Center
RESULTSA total of 243 patients with newly diagnosed urologic cancers were enrolled. The median age was 61 years, with a wide range of 1 to 87 years. Most of the patients (81.47%) were male, while there were 45 females (18.52%) who had either urinary bladder, kidney or upper urothelial cancer. The most common type of malignancy was prostate cancer (34.57%), followed by kidney cancer (30.04%) and urinary bladder cancer (24.69%), consistent with the currently observed worldwide incidence. There were also 3 patients (1.23%) noted with multiple primaries. More than half of the patients (63.37%) received surgery as active treatment. After the two-year follow-up period, thirteen patients (5.35%) developed progressive disease, and 14 patients (5.76%) died.
CONCLUSIONThis urologic cancer registry represents the first multi-center, investigator-initiated epidemiologic study of its kind in the Philippines. As a proof-of-concept (POC) project, it demonstrates the feasibility of establishing a national database capturing baseline data on the country’s most common urologic malignancies.
Cohort Studies ; Multiple Chronic Conditions ; Prostatic Neoplasms ; General Surgery ; Epidemiology
5.Chinese clinical practice guideline for the laparoscopic endoscopic cooperative surgery in gastrointestinal tumor (2025 Shenzhen).
Chinese Journal of Gastrointestinal Surgery 2025;28(1):1-12
With advancements in surgical technology, minimally invasive and function- preserving approaches have become fundamental objectives of both patients and physicians. In recent years, laparoscopic endoscopic cooperative surgery (LECS) has gained increasing attention for its significant role in achieving these goals. However, a notable gap remains in the availability of evidence-based guidelines to standardize the clinical implementation of LECS for gastrointestinal tumors. This guideline is collaboratively developed by the Gastrointestinal Stromal Tumor Committee of the Chinese Anti-Cancer Association, Chinese Gastric Cancer Association, the NOTES Group of the Digestive Endoscopy Branch of the Chinese Medical Association, and the Greater Bay Area Laparoscopic Endoscopic Cooperative Surgery Alliance. Through integrating the current best evidence and experts' opinions, we developed 22 recommendations on 16 clinical questions, including the LECS indications, use of antibiotics, enhanced recovery after surgery, wound suture, and surgical training. This guideline provides comprehensive guidance and recommendations for LECS, aimed at promoting the precise, minimally invasive and function-preserving treatment of gastrointestinal tumors.
Humans
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Laparoscopy/methods*
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Gastrointestinal Neoplasms/surgery*
;
Endoscopy, Gastrointestinal/methods*
;
China
6.Chinese expert consensus on function-preserving gastrectomy for gastric cancer(2025 edition).
Chinese Journal of Gastrointestinal Surgery 2025;28(2):109-120
With the advancement of surgical treatment for gastric cancer surgery, the preservation of gastric function to reduce the post-operative impacts on patients' quality of life, while ensuring effective surgical outcomes, have become both patients' expectations and the pursuit of surgeons. The emergence of the concept of function-preserving gastrectomy (FPG) marks the entry of surgical treatment of gastric cancer into a more personalized and precise era. The "Chinese expert consensus on function - preserving gastrectomy for gastric cancer(2021 edition)" was the first systematic effort to define FPG, outlining its indications and surgical approaches. In recent years, with the rapid development of surgical technologies, such as functional visualization, lymph node tracing, vascular navigation, and multi-omics imaging artificial intelligence (AI), the concept and practice of FPG have continued to evolve. Therefore, led by the the Gastrointestinal Surgery Branch, Surgery Branch, Chinese Medical Association (CMA) with Chinese Society of Surgical Oncology of Chinese Medical Doctor Association (CMDA), Chinese Society of Upper Gastrointestinal Surgeon of CMDA, Stomach and Intestines Committee of Chinese Anticancer Association, and the Gastric Cancer Committee of the Chinese Anticancer Association, a group of experts has come together to update and refine the consensus based on domestic and international literature, as well as recent researches and clinical practice. The definition of FPG remains consistent with the 2021 edition, emphasizing the goal of achieving radical resection for early gastric cancer while minimizing the scope of surgery, selecting appropriate reconstruction methods, and preserving as much gastric function as possible. The main surgical techniques include those that reduce the extent of surgery (such as pylorus-preserving gastrectomy, segmental gastrectomy, local gastric resection, and endoscopic resection), proximal gastrectomy (PG), and distal gastrectomy with vagus nerve preservation. After PG, the surgical reconstruction of the digestive tract involves procedures such as anastomosis between the distal remnant stomach and esophagus, esophagus-tube stomach anastomosis, double tract reconstruction (DTR), interposition jejunostomy, side to side gastroesophagostomy (SOFY), and double flap gastroesophagostomy (Kamikawa anastomosis). In recent years, new anti-reflux techniques have emerged, such as the tube-shaped stomach "Giraffe anastomosis", modified SOFY anastomosis, single flap gastroesophagostomy, arch-shaped anastomosis, and tunnel anastomosis. Functional assessment after FPG primarily includes evaluating remnant gastric function, function-related complications, post-operative nutritional status, and quality of life. This updated consensus is expected to standardize the practice of FPG, provide more personalized surgical treatment options for patients with gastric cancer, and further improve their post-operative quality of life.
Stomach Neoplasms/surgery*
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Humans
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Gastrectomy/methods*
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Consensus
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Quality of Life
;
China
7.Expert consensus on the protection of pelvic organ function in rectal cancer surgery (version 2025).
Chinese Journal of Gastrointestinal Surgery 2025;28(6):575-586
With the development of surgical techniques, adjuvant therapy and neoadjuvant therapy, the survival time of rectal cancer patients after surgery has been significantly improved, but organ dysfunction is still an important problem affecting the quality of life of patients after surgery. With the continuous deepening of clinical research and practice and the updating of relevant theories, more detailed and reliable evidence-based medical evidence has been accumulated in the field of pelvic organ function protection in rectal cancer surgery, and has been continuously verified in the clinical real world at home and abroad. In order to further improve the awareness of domestic physicians on the protection of organ function during the treatment of rectal cancer, standardize the evaluation methods and surgical methods, reduce the incidence of organ dysfunction, and thus improve the quality of life of patients, Society of Colon & Rectal Surgeons of Chinese College of Surgeons of Chinese Medical Doctor Association, Section of Colorectal Surgery of Branch of Surgery of Chinese Medical Association, National Health Commission Capacity Building and Continuing Education Center Colorectal Surgery Committee, and Colorectal and Anal Function Surgeons Committee of China Sexology Association organized the discussion among relevant experts. On the basis of the 2021 edition of the Chinese Expert Consensus on the Protection of Pelvic Organ Function in Rectal Cancer Surgery, the recent evidence-based medical evidence was analyzed and summarized, and the definition, risk factors, evaluation methods, prevention and other issues of organ dysfunction after rectal cancer surgery were analyzed with reference to relevant domestic and foreign studies and combined with clinical practice. Proposed the diagnosis, evaluation and treatment of pelvic organ dysfunction in rectal cancer surgery, and finally formed the "Chinese expert Consensus on the protection of pelvic organ function in rectal cancer surgery (version 2025)".
Humans
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Rectal Neoplasms/surgery*
;
Consensus
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Pelvis/physiopathology*
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Quality of Life
;
Postoperative Complications/prevention & control*
8.Expert consensus on permanent ostomy for colorectal cancer (version 2025).
Chinese Journal of Gastrointestinal Surgery 2025;28(6):587-598
Permanent stoma is an important method often selected in the surgical treatment of colorectal cancer, mainly including but not limited to the sigmoid colon single-lumen stoma after abdominoperineal resection. Since the stoma needs to be retained permanently, preoperative intervention for the stoma, the stoma surgical procedure, prevention and treatment of complications, and long-term postoperative follow-up are all closely related to the patient's quality of life. Under the guidance of the Colorectal Surgery Group of the Society of Surgery, Chinese Medical Association, the Colorectal Tumor Professional Committee of the Chinese Medical Doctor Association, and the Anorectal Physicians Branch of the Chinese Medical Doctor Association, led by the Stoma Study Group of the Anorectal Physicians Branch of the Chinese Medical Doctor Association and with the academic support of Chinese Journal of Gastrointestinal Surgery, experts in related fields were gathered. By drawing on the latest domestic and international guidelines and relevant literature, combining clinical practice and expert opinions, and through repeated discussions and revisions, 24 recommendations were put forward for preoperative evaluation and preparation, surgical technical operation specifications, postoperative management, complication prevention and treatment, and long-term follow-up. The aim is to provide guidance for the clinical practice of permanent stoma in colorectal cancer surgery in China.
Humans
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Colorectal Neoplasms/surgery*
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Consensus
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Ostomy/methods*
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Quality of Life
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Surgical Stomas
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China
;
Colostomy
9.Standardized surgical procedure of proximally extended resection and sphincter-preserving surgery (Tianhe procedure®) for rectal cancer after radiotherapy (2025 version).
Chinese Journal of Gastrointestinal Surgery 2025;28(7):707-716
Tianhe procedure® is a functional sphincter-preserving surgical approach developed for rectal cancer patients following radiotherapy. This technique involves extended proximal resection of the colon beyond the pelvic cavity, followed by anastomosis of the non-irradiated proximal colon to the distal rectum or anal canal. This strategy aims to reduce the incidence of anastomotic complications and postoperative bowel dysfunction. However, there is currently a lack of standardized practice guideline for implementing Tianhe procedure® in China. Therefore, the Chinese Radiation Intestinal Injury Research Group, the Colorectal Surgery Group of Surgery Branch of the Chinese Medical Association, the Anorectal Branch of Chinese Medical Doctor Association, the Colorectal Cancer Committee of the Chinese Medical Doctor Association, and the Colorectal Cancer Committee of China Anti-cancer Association, and the Gastrointestinal Surgical Branch of Guangdong Medical Doctor Association, have jointly convened a panel of national experts to discuss and establish this standardized surgical procedure. This standard, based on the latest evidence from literature, research advancements, and expert experience, focuses on key aspects of the Tianhe procedure®, including its precise definition, indications, critical procedural steps, postoperative complications, and functional rehabilitation strategies. It aims to promote standardized implementation and broader clinical adoption of this innovative surgical technique.
Humans
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Rectal Neoplasms/radiotherapy*
;
Anal Canal/surgery*
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Anastomosis, Surgical/methods*
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Organ Sparing Treatments/methods*
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Rectum/surgery*
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Postoperative Complications/prevention & control*
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Digestive System Surgical Procedures/methods*
10.Expert consensus on the diagnosis and treatment of low anterior resection syndrome (2025 edition).
Chinese Journal of Gastrointestinal Surgery 2025;28(8):832-844
Low anterior resection syndrome (LARS) is a common bowel dysfunction syndrome following sphincter-preserving surgery for rectal cancer, characterized by stool storage dysfunction and evacuatory dysfunction. It has become a critical factor adversely affecting patients' quality of life and long-term clinical outcomes. Currently, the pathogenic mechanisms of LARS remain incompletely elucidated, and high-quality evidence to guide clinical practice is still lacking. However, emerging evidence suggests that strategic optimization across the clinical management pathway-including precision oncology planning, surgical technique selection, multidimensional symptom profiling, proactive prevention protocols, and comprehensive symptom management-may effectively reduce LARS severity and improve survivorship outcomes. Given the absence of consensus guidelines for LARS management among clinicians across China, the Chinese Society of Coloproctology (Chinese Medical Doctor Association) organized domestic experts in relevant fields. Through systematic review of global research findings, integration of international expertise and guidelines, and adaptation to domestic clinical realities, we developed the "Chinese Expert Consensus on the Diagnosis and Treatment of Low Anterior Resection Syndrome (2025 Edition)". This consensus elaborates on key aspects including the definition, clinical manifestations, risk factors, pathophysiological mechanisms, symptom assessment, treatment modalities, and prevention strategies for LARS, aiming to standardize the diagnosis and management of LARS in China.
Humans
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Rectal Neoplasms/surgery*
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Consensus
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Postoperative Complications/therapy*
;
Quality of Life
;
Syndrome
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China
;
Low Anterior Resection Syndrome


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