中华胃肠外科杂志最新文献

{"title":"[Expert consensus on the prevention, treatment and rehabilitation of pelvic organ dysfunction after rectal cancer surgery(2026 version)].","authors":"","doi":"10.3760/cma.j.cn441530-20251028-00404","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20251028-00404","url":null,"abstract":"<p><p>With the remarkable improvement in the survival rate of patients after sphincter-preserving radical resection for rectal cancer, pelvic organ dysfunction has become a core issue affecting patients' quality of life. However, in clinical practice, there is a lack of standardized assessment of pelvic organ function and systematic rehabilitation strategies. To address this issue, the Colorectal Cancer Committee of the Chinese Medical Doctor Association, the Colorectal Cancer Committee of the Chinese Anti-Cancer Association, the Neuromodulation Committee of the Chinese Medical Doctor Association, and the Colorectal and Anal Functional Surgery Branch of the Chinese Society of Andrology jointly initiated the formulation of this consensus. They organized domestic experts engaged in the diagnosis and treatment of rectal cancer and related fields, systematically reviewed relevant domestic and international studies, and combined clinical practice. Centering on the incidence, risk factors, assessment methods, prevention, treatment and rehabilitation of postoperative organ dysfunction in rectal cancer, under the guidance of the integrated concept of \"prevention-treatment-rehabilitation\", and integrating the multidisciplinary wisdom of gastrointestinal surgery, urology, sexual medicine, rehabilitation medicine and other disciplines, the experts standardized the pelvic organ function assessment strategies, surgical techniques and dysfunction rehabilitation strategies in three stages of \"preoperative assessment - intraoperative protection - postoperative rehabilitation\", put forward recommendations, and conducted discussions and voting, thus formulating « Expert consensus on the prevention, treatment and rehabilitation of pelvic organ dysfunction after rectal cancer surgery (2026 version) ». This consensus aims to raise the awareness of domestic clinicians regarding organ function protection during the treatment of rectal cancer, standardize the implementation of organ function assessment and surgical methods, develop a rehabilitation strategy for recto-vesical-sexual dysfunction after sphincter-preserving rectal cancer surgery suitable for national conditions to reduce the incidence of organ dysfunction, and provide solutions for the rehabilitation of pelvic organ dysfunction in patients while ensuring the curative effect of radical rectal cancer treatment.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"409-423"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical analysis of pseudomyxoma peritonei presenting with external abdominal hernia as the initial symptom].","authors":"R Yang, Y B Fu, X L Liang, Q Y Zheng, S L Wang, Y Li","doi":"10.3760/cma.j.cn441530-20251229-00484","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20251229-00484","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the clinical characteristics and key points of diagnosis and treatment in patients with pseudomyxoma peritonei (PMP) presenting with external abdominal hernia as the initial manifestation. <b>Methods:</b> A descriptive case-series study was conducted. From May 2015 to September 2024, a total of 569 patients diagnosed with PMP and treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) were admitted to Beijing Shijitan Hospital. Among them, 13 patients (2.3%) presented with external abdominal hernia as the initial clinical manifestation. Clinical data of these 13 patients were retrospectively analyzed, including the type of inguinal hernia, pathological diagnosis, peritoneal cancer index (PCI), interval from pathological diagnosis to first CRS+HIPEC, completeness of cytoreduction (CC) score, operation duration, and serious adverse events within 30 postoperative days and prognosis. <b>Results:</b> The median age of the 13 patients was 51 years (range 33-71 years), including 10 males. Twelve patients presented with inguinal hernia as the initial symptom: 6 with right inguinal hernia, 5 with left inguinal hernia, and 1 with bilateral inguinal hernia. The remaining 1 patient had an umbilical hernia. The hernia contents were tumor tissue and mucus in 11 patients, while 2 patients had complete spontaneous reduction of hernia contents. Pathological diagnosis showed low-grade in 10 cases, acellular mucus, high-grade, and high-grade with signet-ring cells in 1 case each. The median interval from pathological diagnosis to first standard CRS+HIPEC was 2.5 (range 0.6-11.6) months . Perioperative assessment showed that 7 patients had PCI < 20, 9 patients had CC score 0-1, median ascites volume was 800 (range 0-20 000) ml, median Karnofsky performance status score was 90 (range 80-100), and median operation duration was 655 (range 403-1018) minutes . Seven patients developed postoperative serious adverse events: 4 involving the respiratory system, 1 the circulatory system, 1 the digestive system, and 1 with infection. No deaths occurred within 30 postoperative days. The median follow-up was 61.2 months (95%<i>CI</i>: 36.3-86.1), the mean overall survival was 124.3 months (95%<i>CI</i>: 92.1-156.6), and 2 patients died. <b>Conclusions:</b> In PMP patients presenting with external abdominal hernia as the initial symptom, inguinal hernia is the most common type, and most hernia contents cannot be reduced spontaneously. If PMP is suspected during surgery for external abdominal hernia, prompt referral to a specialized peritoneal metastasis center for CRS+HIPEC is recommended.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"505-509"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of misdiagnosis of abdominal free body as teratoma].","authors":"X B Ge, K X Shen, T J Zhang, J P Yu, Z S Xie","doi":"10.3760/cma.j.cn441530-20250807-00293","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250807-00293","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"533-535"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Focusing on occupational safety in hyperthermic intraperitoneal chemotherapy: a systematic review].","authors":"J J Fang, R J Chen, K B Ouyang, R J Li, Z F Yang, Y Li","doi":"10.3760/cma.j.cn441530-20260129-00064","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20260129-00064","url":null,"abstract":"<p><p>Hyperthermic Intraperitoneal Chemotherapy (HIPEC) serves as a core treatment modality for malignant tumors on the peritoneal surface, with its clinical application growing increasingly widespread. However, the potential genotoxicity, teratogenicity, and carcinogenicity of chemotherapy drugs expose healthcare workers to occupational risks. This review systematically analyzes 10 relevant research papers, organizing existing evidence on HIPEC occupational safety around five core variables: collective protective equipment, personal protective equipment, air sample monitoring, surface sampling monitoring, and biological sample monitoring. Results indicate that overall occupational exposure risks during HIPEC are relatively low. Chemotherapy drugs were mostly undetectable or below detection limits in air samples. Surface contamination, such as the outer surface of gloves, the floor in surgical areas, and equipment reservoirs,represents primary risk points. Protective measures including double- or triple-layer gloves and fume extraction systems can effectively reduce exposure risks. Biological sample monitoring indicates that chemotherapy drug markers were not detected in the urine or plasma of most healthcare workers. However, a few studies have identified irinotecan and its active metabolites in red blood cells.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"518-527"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Strategies for the prevention and treatment of peritoneal metastases in large Borrmann type III and type IV gastric cancer].","authors":"C Yan, S Lu, Z G Zhu","doi":"10.3760/cma.j.cn441530-20260202-00073","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20260202-00073","url":null,"abstract":"<p><p>Large Borrmann type III (with maximum tumor diameter ≥8 cm) and Borrmann type IV gastric cancers typically show diffuse infiltration with ill-defined borders and a high frequency of serosal invasion and positive peritoneal lavage cytology, resulting in a high risk of postoperative peritoneal recurrence. Current clinical strategies focus on preventing peritoneal metastasis or recurrence, emphasizing the optimization of perioperative systemic therapy based on precise stratification through staging laparoscopy combined with peritoneal lavage cytology, and exploring the rational combination of triple-drug chemotherapy with immunotherapy and molecular targeted therapy, as well as the screening of suitable populations. Intraperitoneal regional therapy is still in the evidence accumulation phase, requiring combination with standardized surgery and perioperative management, and high-quality prospective studies should be conducted to validate outcomes related to peritoneal recurrence. This article reviews the progress in the prevention and treatment of peritoneal metastasis in large Borrmann type III (with maximum tumor diameter ≥8 cm) and type IV gastric cancer, providing references for clinical decision-making and research design.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"454-462"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei: results from a 940-case multicenter real-world study].","authors":"Y R Cui, R Ma, G L Ren, R Yang, X J Yang, S L An, G B Wu, X B Li, S C Lai, Y Li","doi":"10.3760/cma.j.cn441530-20260105-00011","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20260105-00011","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate long-term survival, perioperative severe adverse events, and prognostic factors in pseudomyxoma peritonei (PMP) treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) in a multicenter real-world cohort. &lt;b&gt;Methods:&lt;/b&gt; This was a retrospective observational study. Based on a multicenter joint database, clinicopathological data were collected from 940 patients with PMP who underwent CRS+HIPEC between January 2004 and November 2025 across four hospitals in the Peritoneal Oncology Specialty Alliance: Beijing Shijitan Hospital, Capital Medical University (n=532), Beijing Tsinghua Changgung Hospital, Tsinghua University (n=388), Zhongnan Hospital of Wuhan University (n=18), and Shijiazhuang People's Hospital (n=2).Long-term survival and perioperative severe adverse events were documented in this PMP cohort. Cox regression was used to identify independent prognostic risk factors, and interaction tests as well as stratified joint-effect analyses were performed. &lt;b&gt;Results:&lt;/b&gt; A total of 418 (44.5%) males and 522 (55.5%) females were included, among whom 348 (37.0%) patients were aged ≥60 years. Histopathological types were as follows: acellular mucin in 20 cases (2.1%), low-grade PMP in 511 cases (54.4%), high-grade PMP in 302 cases (32.1%), and high-grade PMP with signet ring cells in 107 cases (11.4%). A total of 587 patients (62.4%) received CRS+HIPEC for the first time. The median operative time was 592 (range, 120-1080) minutes. A total of 695 patients (73.9%) had a peritoneal cancer index (PCI) score ≥20, and 434 patients (46.2%) had a completeness of cytoreduction (CC) score of 2-3. The incidence of perioperative severe adverse events was 27.0% (254/940). The median follow-up duration of this cohort was 39.6 (0.5-254.6) months, and the median overall survival (OS) was 116.7 months (95%CI: 99.2-134.1). Multivariate Cox regression analysis revealed that body mass index (HR=0.92, &lt;i&gt;P&lt;/i&gt;&lt;0.01), history of abdominal surgery (HR=0.40, &lt;i&gt;P&lt;/i&gt;&lt;0.01), number of organ resections (HR=0.58, &lt;i&gt;P&lt;/i&gt;&lt;0.01), PCI score (HR=1.65, &lt;i&gt;P&lt;/i&gt;=0.04), CC score (HR=1.37, &lt;i&gt;P&lt;/i&gt;=0.03), intraoperative blood loss (HR=1.00, &lt;i&gt;P&lt;/i&gt;=0.03), pathological subtype (HR=1.90, &lt;i&gt;P&lt;/i&gt;&lt;0.01), Ki-67 index (HR=1.67, &lt;i&gt;P&lt;/i&gt;=0.01), preoperative carcinoembryonic antigen (CEA) (HR=1.45, &lt;i&gt;P&lt;/i&gt;=0.03), preoperative carbohydrate antigen 125 (CA125) (HR=2.31, &lt;i&gt;P&lt;/i&gt;&lt;0.01), postoperative CEA (HR=1.45, &lt;i&gt;P&lt;/i&gt;=0.03), and lymph node metastasis (HR=1.88, &lt;i&gt;P&lt;/i&gt;&lt;0.01) were independent prognostic factors. Interaction testing showed that the risk of death was significantly increased in patients with PCI ≥20 and CC score 2-3 (HR=2.32, 95%CI: 1.46-3.67, &lt;i&gt;P&lt;/i&gt;&lt;0.01); significantly decreased in patients with normal preoperative CEA and ≥2 organ resections (HR=0.31, 95%CI: 0.15-0.62, &lt;i&gt;P&lt;/i&gt;&lt;0.01); and significantly increased in patients with Ki-67 &gt;15% and normal preoperative CEA (HR=6.34, 95%CI: 1.50-26.84","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"492-498"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinicopathologic features and prognosis of retroperitoneal unicentric Castleman disease: report of 38 patients].","authors":"B Ke, B Y Zhou, F L Zang, P Jin, H M Liu, H Liang, R P Zhang, G Ma","doi":"10.3760/cma.j.cn441530-20250721-00275","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250721-00275","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical and pathological characteristics and prognosis of retroperitoneal unicentric Castleman disease (UCD). <b>Methods:</b> This study employed a retrospective observational research design. The inclusion criteria were: (1) postoperative pathological confirmation of Castleman disease; (2) patients underwent surgical treatment; (3) preoperative imaging diagnosis of a retroperitoneal unicentric lesion; (4) complete clinicopath- ological data. Exclusion criteria: (1) received preoperative antitumor therapy; (2) had a history of other malignancies within the past 5 years. According to these criteria, clinicopathological and follow-up data of 38 patients with retroperitoneal UCD treated at Tianjin Medical University Cancer Hospital from January 2015 to August 2024 were collected. The clinicopathological characteristics and prognosis were analyzed. <b>Results:</b> Among the 38 patients with retroperitoneal UCD, there were 12 males and 26 females. The mean age was (42.8±15.4) years (range, 18-70 years), and the mean maximum tumor diameter was (5.8±2.3) cm. The disease had no specific clinical manifestations, and 28 cases (73.7%) were detected during physical examination. Of the 38 patients, 35 (92.1%) underwent radical resection, while 3 (7.9%) received intracapsular piecemeal resection due to large, invasive tumor growth. Postoperative pathology revealed that 32 cases (84.2%) were of the hyaline vascular type, and 3 cases (7.9%) each were of the plasma cell type and mixed type, respectively. The median follow-up duration was 32.4 months (range, 3-78 months). Eight patients were lost to follow-up, 6 died of other diseases, and the remaining 24 patients had no recurrence during postoperative follow-up (including 3 patients who underwent piecemeal resection, with no tumor progression). Competing risk model analysis showed that the 5-year tumor-specific survival rate of patients with retroperitoneal UCD after surgical treatment was 100%. In the sensitivity analysis, the 5-year survival rate under the worst-case scenario was 75.0%. <b>Conclusions:</b> Retroperitoneal unicentric Castleman disease has a low incidence and lacks specific clinical manifestations. Surgical treatment is the main therapeutic approach, and patients have a favorable prognosis.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"499-504"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[International frontier advances and practice in the diagnosis and management of pseudomyxoma peritonei].","authors":"Y Li, H Wang, Q Y Zheng, Y B Fu","doi":"10.3760/cma.j.cn441530-20260201-00072","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20260201-00072","url":null,"abstract":"<p><p>The academic research course of pseudomyxoma peritonei (PMP) has been tortuous and long. It is not until the past 40 years that a cognitive system consistent with the core theories of oncology has gradually been formed, and the level of clinical diagnosis and treatment has also made considerable progress. A comprehensive treatment technology system centered on cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been established. This article sorts out and summarizes the cutting-edge research progress in the field of PMP at the 15th International Peritoneal Cancer Congress, combines clinical practice to explore its enlightenment for clinical work, scientific research exploration, and the construction of peritoneal oncology discipline in China, aiming to provide reference for the standardized diagnosis and treatment of PMP and related research in China.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"445-449"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pressurized intraperitoneal aerosol chemotherapy (PIPAC): techniques, operational specifications and occupational protection recommendations (2026 version)].","authors":"","doi":"10.3760/cma.j.cn441530-20260313-00094","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20260313-00094","url":null,"abstract":"<p><p>Peritoneal metastasis is a common pattern of metastasis for gastrointestinal and ovarian malignancies and is associated with an extremely poor prognosis. Recently, Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC), a novel locoregional drug delivery technology, has garnered significant attention. It delivers low-dose aerosolized chemotherapeutic drugs into the abdominal cavity, utilizing capnoperitoneum pressure and aerosol properties to achieve a more homogeneous spatial distribution and superior tissue penetration. Currently, numerous international studies have demonstrated the favorable safety, tolerability, and efficacy of PIPAC, leading to established expert consensus on its indications, technical procedures, and safety measures. However, a systematic and standardized PIPAC operational protocol remains lacking in China, owing to limited equipment accessibility and insufficient clinical evidence. Based on current research progress and international consensus, combined with characteristics of the domestic PIPAC system equipped with a high-pressure peristaltic pump and preliminary domestic clinical experiences, this paper formulates technical specifications and occupational protection recommendations for PIPAC in China. It systematically elaborates on patient selection, perioperative preparation, standardized operational procedures, and safety measures. This study aims to provide actionable and replicable technical guidance, ensuring treatment safety and operational reproducibility, thereby facilitating the standardized application and clinical promotion of PIPAC in China.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"393-408"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress in local therapy for gastrointestinal peritoneal metastatic tumors].","authors":"P Zhang, K Ma, W J Zhang, P F Ni, C Q Wu, K X Tao","doi":"10.3760/cma.j.cn441530-20260124-00056","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20260124-00056","url":null,"abstract":"<p><p>Peritoneal metastasis (PM) is a common manifestation of advanced solid tumors such as colorectal cancer and gastric cancer. Traditional systemic chemotherapy has limited efficacy due to the blood-peritoneal barrier. With the development of local treatment technologies, the therapeutic model has shifted to \"systemic+local\" combined therapy. This article systematically summarizes mainstream local treatment options, including core technologies such as cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC), as well as the operational standards, indications, and clinical evidence of combined strategies like CRS+HIPEC. Meanwhile, it analyzes the differences in individualized treatment pathways for PM derived from different tumors. Studies have shown that CRS+HIPEC, as the core curative scheme, can significantly prolong the survival of some patients; minimally invasive technologies such as PIPAC and normothermic intraperitoneal chemotherapy (NIPEC) provide new options for patients intolerant to major surgery; the combination of targeted therapy, immunotherapy, and local treatment shows synergistic potential. Currently, this field still faces challenges such as unbalanced evidence levels and inconsistent selection criteria. In the future, efforts should focus on precision, minimally invasive, and individualized development, optimizing treatment strategies through multi-omics technologies and evidence-based research to improve patient prognosis.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"29 4","pages":"536-544"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}