Malignant intestinal obstruction is one of the common clinical symptoms of peritoneal metastasis of colorectal cancer, and its pathophysiological mechanism involves various factors such as local invasion and compression of tumors, intestinal adhesions caused by the formation of scattered nodules in the abdominal cavity, inflammatory response in the abdominal cavity, and neuromodulation disorders. Patients with traditional intestinal obstruction are generally treated with surgery, but patients with malignant intestinal obstruction associated with peritoneal metastasis of colorectal cancer can present with multi-level obstruction, complex and diverse symptoms. Combined with multiple metastases in the abdominal cavity and even accompanied by cachexia, malignant intestinal obstruction as a major treatment problem in the field of colorectal surgery is often difficult to be treated by surgery. What's more, it is worth noting that new progress and breakthroughs have been made in the diagnosis and treatment of peritoneal metastasis of colorectal cancer, and the treatment of cancerous intestinal obstruction has also begun to receive extensive attention. Therefore, this article summarizes the clinical features of peritoneal metastasis-related malignant intestinal obstruction in colorectal cancer and looks forward to its treatment challenges.

Peritoneal metastasis is a common form of distant metastasis in patients with colorectal cancer, and it is typically associated with a poor prognosis. The development of peritoneal metastasis involves complex molecular mechanisms and multifactorial regulation of the tumor microenvironment. Due to the presence of the blood-peritoneal barrier, only a small amount of systemic medication reaches the peritoneal cavity, resulting in limited efficacy against peritoneal metastasis. Intraperitoneal administration shows significant therapeutic advantages as it can directly target the tumor microenvironment, maintain high local drug concentrations, and reduce systemic toxicity. Intraperitoneal chemotherapy, especially hyperthermic intraperitoneal chemotherapy, has become a cornerstone therapeutic strategy in the clinical treatment of peritoneal metastasis. When selecting chemotherapy drugs and drug combinations, pharmacokinetic properties, efficacy, and safety must be comprehensively considered to optimize the treatment outcomes. In addition, the unique microenvironment of the peritoneal cavity provides new treatment approaches for biological treatment strategies, including antitoxins, vaccines, immune checkpoint inhibitors, etc. Techniques such as pressurized intraperitoneal aerosol chemotherapy and novel drug delivery systems demonstrate potential for enhanced efficacy, offering promising alternatives to improve patient outcomes. This article will review peritoneal barrier characteristics, intraperitoneal drug transport, intraperitoneal chemotherapy, and intraperitoneal biological therapies, thereby establishing a theoretical framework for precision therapy in colorectal cancer peritoneal metastasis.

Malignant intestinal obstruction is one of the common clinical symptoms of peritoneal metastasis of colorectal cancer, and its pathophysiological mechanism involves various factors such as local invasion and compression of tumors, intestinal adhesions caused by the formation of scattered nodules in the abdominal cavity, inflammatory response in the abdominal cavity, and neuromodulation disorders. Patients with traditional intestinal obstruction are generally treated with surgery, but patients with malignant intestinal obstruction associated with peritoneal metastasis of colorectal cancer can present with multi-level obstruction, complex and diverse symptoms. Combined with multiple metastases in the abdominal cavity and even accompanied by cachexia, malignant intestinal obstruction as a major treatment problem in the field of colorectal surgery is often difficult to be treated by surgery. What's more, it is worth noting that new progress and breakthroughs have been made in the diagnosis and treatment of peritoneal metastasis of colorectal cancer, and the treatment of cancerous intestinal obstruction has also begun to receive extensive attention. Therefore, this article summarizes the clinical features of peritoneal metastasis-related malignant intestinal obstruction in colorectal cancer and looks forward to its treatment challenges.

Peritoneal metastasis is a common form of distant metastasis in patients with colorectal cancer, and it is typically associated with a poor prognosis. The development of peritoneal metastasis involves complex molecular mechanisms and multifactorial regulation of the tumor microenvironment. Due to the presence of the blood-peritoneal barrier, only a small amount of systemic medication reaches the peritoneal cavity, resulting in limited efficacy against peritoneal metastasis. Intraperitoneal administration shows significant therapeutic advantages as it can directly target the tumor microenvironment, maintain high local drug concentrations, and reduce systemic toxicity. Intraperitoneal chemotherapy, especially hyperthermic intraperitoneal chemotherapy, has become a cornerstone therapeutic strategy in the clinical treatment of peritoneal metastasis. When selecting chemotherapy drugs and drug combinations, pharmacokinetic properties, efficacy, and safety must be comprehensively considered to optimize the treatment outcomes. In addition, the unique microenvironment of the peritoneal cavity provides new treatment approaches for biological treatment strategies, including antitoxins, vaccines, immune checkpoint inhibitors, etc. Techniques such as pressurized intraperitoneal aerosol chemotherapy and novel drug delivery systems demonstrate potential for enhanced efficacy, offering promising alternatives to improve patient outcomes. This article will review peritoneal barrier characteristics, intraperitoneal drug transport, intraperitoneal chemotherapy, and intraperitoneal biological therapies, thereby establishing a theoretical framework for precision therapy in colorectal cancer peritoneal metastasis.

Objective To promote the construction of a national party building indicator system for public hospitals,provide reference for the development of system documents such as quality evaluation methods for party building work in public hospitals.Methods Conduct a comprehensive and systematic collection,organization,and analysis of policy documents related to party building in public hospitals in China since 2018,and organize expert discussions.Results The positive coefficients of the three rounds of expert discussions were all 100％,and the expert authority coefficient was 0.878.A party building indicator system was constructed with 7 primary indicators and 40 secondary indicators,including leadership system and decision-making mechanism,leadership team and cadre talent team construction,grassroots party organization construction,party member team construction,medical ethics and clean governance construction,party building work guarantee,and others.Conclusion The indicator system has been unanimously recognized by experts and is authoritative and feasible,laying the foundation for the refined party building work in public hospitals.