中华胃肠外科杂志最新文献

{"title":"[Shanghai consensus on the diagnosis and treatment of gastroesophageal reflux disease in patients undergoing sleeve gastrectomy(2024 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20240819-00290","DOIUrl":"10.3760/cma.j.cn441530-20240819-00290","url":null,"abstract":"<p><p>Morbid obesity and its accompanying diseases have become one of the most serious public health problems warranting global effort and bariatric and metabolic surgery is still the most effective method for long-term weight control. Among all bariatric and metabolic procedures, sleeve gastrectomy is currently the most widely used, but it is not a perfect procedure. One of the most serious issues that this surgical procedure faces is the possibility of worsening existing or developing <i>de novo</i> gastroesophageal reflux disease after surgery. Moreover, there is currently a lack of high-level clinical trial evidence on the diagnosis and treatment of gastroesophageal reflux disease in patients undergoing sleeve gastrectomy. Therefore, initiated by four domestic bariatric and metabolic surgery centers, 41 experts with rich experience in bariatric and metabolic surgery and diagnosis and treatment of gastroesophageal reflux disease from China, Japan, and South Korea reached a consensus on the diagnosis and treatment of gastroesophageal reflux disease in sleeve gastrectomy patients using the Delphi method. There are a total of 59 consultation questions in this consensus, of which 44 have reached a consensus. We hope that this consensus can not only serve as a reference for clinical diagnosis and treatment, but also provide more possible directions for future high-quality clinical research.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"863-878"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308676","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":"[Lymph distant and skip metastasis of esophageal cancer based on the membrane anatomy theory].","authors":"G J Wang","doi":"10.3760/cma.j.cn441530-20240710-00241","DOIUrl":"10.3760/cma.j.cn441530-20240710-00241","url":null,"abstract":"<p><p>This study elaborates the essence of distant lymph node metastasis and skip metastasis of esophageal cancer according to the membrane anatomy theory. Lymph distant metastasis of esophageal cancer is essentially the phenomenon of cancer cells shedding from the primary focus of esophageal cancer and transferring along the direction of lymphatic drainage to the root of the esophageal mesentery. Because the metastasis is relatively distant, it is called distant metastasis. Despite the long distance, this metastasis is still limited to the envelope-like-membrane structure of the esophageal mesentery and belongs to the category of mesangial carcinoma. The lymph node skip metastasis of esophageal cancer refers to the process in which esophageal cancer cells detach from the primary lesion and migrate along the lymphatic drainage direction within the envelope-like-membrane structure of the mesentery to the central lymph nodes at the root of the mesentery. During this metastatic process, the surrounding mesenteric lymph nodes which are tightly attached to the esophagus will not be affected by cancer metastasis because of the isolation barrier effect of the envelope-like membrane structure of the esophageal mesentery. Applying the theory of membrane anatomy to esophageal cancer radical surgery will make the surgery more scientific, reasonable, and standardized, and is expected to achieve dual benefits of both surgical and oncological effects in esophageal cancer radical surgery.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"904-908"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308672","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":"[Distribution pattern of the rectal circumferential fascia and its clinical significance: An anatomical study].","authors":"X J Wang, Y Deng, Z F Zheng, Y Huang, P Chi","doi":"10.3760/cma.j.cn441530-20240710-00242","DOIUrl":"10.3760/cma.j.cn441530-20240710-00242","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the pattern of distribution of the circumferential fascia of the rectum and elucidate its clinical implications. &lt;b&gt;Methods:&lt;/b&gt; In this descriptive study, we examined the gross anatomy of four male hemipelvic cadaveric specimens from the Department of Anatomy at Fujian Medical University and the histological features of 16 fresh postoperative specimens from patients who had undergone total mesorectal excision for rectal cancer at the Department of Colorectal Surgery, Union Hospital, Fujian Medical University, between January and December 2022. The resultant combination of gross anatomical and histological features was employed to assess the following areas: (1)the morphology of the anterior mesorectum and fascia at the peritoneal reflection; (2)the caudal attachment point of Denonvilliers' fascia; (3) the fusion area of the pelvic plexus and the pre-hypogastric fascia; (4)the lateral and posterior attachment edges of the rectosacral fascia; and (5) selected histological features. &lt;b&gt;Results:&lt;/b&gt; Our findings were as follows. (1) At the peritoneal reflection, the anterior mesorectum forms a triangular fat pad with a dense fascial structure. The base of this pad extends anteriorly across the most caudal point of the peritoneal reflection, with Denonvilliers' fascia originating from the anterior side of the triangle, near the bladder side of the peritoneum craniad to the peritoneal reflection. (2) The caudal attachment of Denonvilliers' fascia is at the angle between the seminal vesicles, the ampulla of the vas deferens, and the prostate. It adheres tightly to the prostatic capsule and vascular bundles pass through its cephalic side. (3) The pre-hypogastric fascia transitions laterally to merge with Denonvilliers' fascia; its middle part being inseparable from the main body of the pelvic plexus, which gives rise to the nerves that innervate the rectum. (4) The rectosacral fascia is formed by fusion of the fascia propria with the pre-hypogastric fascia. The resultant fused fascia bifurcates into two leaves on the right side; the outer leaf being the pre-hypogastric fascia and the inner leaf the fascia propria. (5) Histologically, the peritoneal reflection zone shows cuboidal epithelium of the peritoneum at its lowest point with no detectable origin of Denonvilliers' fascia. The anterior side of the peritoneal reflection, from which Denonvilliers' fascia originates, has a dense double-layered fascial structure comprising thick collagen fiber (16/16). The fascia propria exhibits a thinner and looser collagen fiber structure and its origin varies between individuals, 13/16 originating together with Denonvilliers' fascia from the craniad side of the peritoneal reflection, and 3/16 originating separately from the most caudal point of the peritoneal reflection. The caudal edge of Denonvilliers' fascia has a double-layered fascial structure with multiple S100-stained areas. The posterior edge of the rectosacral fascia","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"919-927"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308668","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":"[Learning curve for a five-step procedure, transthoracic single-port assisted laparoscopic transabdominal diaphragmatic approach, for Siewert type II adenocarcinoma of the esophagogastric junction].","authors":"H P Zeng, Y H Chen, L J Luo, Z J Zhang, Z Y Lin, Y Chen, Y H Peng, T Wang, Y S Zheng, W W Xiong, W Wang","doi":"10.3760/cma.j.cn441530-20240116-00028","DOIUrl":"10.3760/cma.j.cn441530-20240116-00028","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the learning curve for a five-step procedure, namely, a transthoracic single-port assisted laparoscopic transabdominal diaphragmatic approach, for Siewert type II adenocarcinoma of the esophagogastric junction. &lt;b&gt;Methods:&lt;/b&gt; In this retrospective cohort study, we analyzed relevant clinical data of 66 patients with Siewert type II adenocarcinoma of the esophagogastric junction who had undergone the five-step procedure performed by the same surgeon in the Gastrointestinal Surgery Department of Guangdong Provincial Hospital of Chinese Medicine from May 2017 to April 2023. The learning curve were plotted using cumulative summation analysis and selected indicators, including intraoperative blood loss, duration of surgery, time to first flatus, time to first tolerance of liquid food, length of hospital stay, and incidence of perioperative complications at different stages were compared. The data were analyzed using SPSS 24.0 statistical software. Numerical data are presented as cases (%) and data were analyzed using the χ&lt;sup&gt;2&lt;/sup&gt; test or Fisher's exact test. Normally distributed measurement data are presented as &lt;i&gt;x±s&lt;/i&gt;, and independent sample t-testing was performed for inter group comparison. Non-normally distributed measurement data are presented as &lt;i&gt;M&lt;/i&gt;(&lt;i&gt;Q&lt;/i&gt;&lt;sub&gt;1&lt;/sub&gt;, &lt;i&gt;Q&lt;/i&gt;&lt;sub&gt;3&lt;/sub&gt;) and the Mann-Whitney U test was used for inter group comparison. &lt;b&gt;Results:&lt;/b&gt; The five-step procedure had been successfully completed without switching to open surgery in all 66 study patients. There were no perioperative deaths, blood loss was 100 (50, 200) mL and duration of surgery 329.4±87.3 minutes. The equation of optimal fit for the duration of surgery was y=0.031x&lt;sup&gt;3&lt;/sup&gt;-4.4757x&lt;sup&gt;2&lt;/sup&gt;+164.97x-264.4 (&lt;i&gt;P&lt;/i&gt;&lt;0.001, &lt;i&gt;R&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0.9797). The cumulative summation learning curve reached a vertex when 25 surgical procedures had accumulated. Using 25 cases as the cut-off, we divided the learning curves into learning and proficiency periods and patients into learning (25) and proficiency period groups (41). There were no statistically significant differences between the two groups of patients in sex, age, body mass index, American Society of Anesthesiologists score, history of abdominal surgery, comorbidities, preoperative neoadjuvant therapy, maximum tumor diameter, surgical procedure, or T and N stage of tumor (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The following factors differed significantly (all &lt;i&gt;P&lt;/i&gt;&lt;0.05) between the learning and proficiency stages: in the latter there was less intraoperative blood loss (100 [50, 100] ml vs. 200 [100, 200] ml, &lt;i&gt;U&lt;/i&gt;=-3.940, &lt;i&gt;P&lt;/i&gt;&lt;0.001), shorter duration of surgery ([289.8±50.7] minutes vs. [394.4±96.0] minutes, &lt;i&gt;t&lt;/i&gt;=5.034, &lt;i&gt;P&lt;/i&gt;&lt;0.001), more mediastinal lymph nodes removed (5 [2, 8] vs. 2 [1, 5], &lt;i&gt;U&lt;/i&gt;=-2.518, &lt;i&gt;P&lt;/i&gt;=0.012), earlier time to first flatus (2 [2, 3] days vs. 4 [3, 6] days, &lt;i&gt;U&lt;/i&gt;=-4.016, &lt;i&gt;P&lt;/i&gt;&lt;0.001), earlier time to first ","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"938-944"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308671","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 report of ectopic small intestine and colon with absence of suspensory ligament of duodenum].","authors":"M X Zhang, B Q Liang, M E Li, C L Yang, R T Wei, Y Zhang, Y G Dai","doi":"10.3760/cma.j.cn441530-20240112-00024","DOIUrl":"10.3760/cma.j.cn441530-20240112-00024","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"980-981"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308662","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 application of parasacral artery perforator flap in the treatment of Pilonidal Sinus Diseases].","authors":"J H Lan, Z H Chen, Y Y Fan, L Han, T Wang, C Y Jia, W L He","doi":"10.3760/cma.j.cn441530-20231017-00137","DOIUrl":"10.3760/cma.j.cn441530-20231017-00137","url":null,"abstract":"<p><p><b>Objective:</b> To investigate clinical efficacy of parasacral perforator flap (PPF) on postoperative wound healing in pilonidal sinus diseases (PSDs). <b>Methods:</b> The surgery steps were as follows: (1) To preoperatively detect parasacral perforator arteries with the handhold Doppler probe and mark them; (2) To remove the infected and necrotic tissues of PSDs completely; (3) To design the PPF according to the wound size and the parasacral perforator arteries' localization; (4) To harvest the flap from the gluteus maximus muscle surface and transfer it to the wound without tension. Several data were documented, including surgical duration, flap length, flap width, drainage tube placement duration, hospital stay, duration from operation to stitch removal, postsurgical complications and recurrence. <b>Results:</b> There were six patients with PSDs whose postoperative wound healing was repaired by PPF, admitted in our department from March 2021 to March 2023. Of them, five were male and one was female. Their median age was 24 (range: 18-33) years old. Their median surgical duration was 165 (range: 134-207) minutes, median length of PPF was 8 (range: 7-11) cm, median width of PPF was 3 (range: 3-4) cm, mean duration of drainage tube placement was 8 (range: 4-17) days, mean hospital stay was 13 (range: 6-23) days, mean duration from operation to stitch removal was 14 (range: 14-17) days, median follow-up time was 6-16 months. Incisions of all six cases achieved first-intention healing without early- or late-stage complications. No recurrence occurred during follow-up. All patients involved were satisfied with their clinical efficacy. <b>Conclusion:</b> The utility of PPF in postoperative wound healing of PPDs was effective, safe and reliable.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"970-973"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308665","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":"[Fascial anatomy of ligamentous structures associated with colon cancer surgery].","authors":"X J Wang","doi":"10.3760/cma.j.cn441530-20240708-00237","DOIUrl":"10.3760/cma.j.cn441530-20240708-00237","url":null,"abstract":"<p><p>The ligamentous structures integral to the surgical management of colon cancer include the gastrocolic ligament, the phrenicocolic ligament, and the splenocolic ligament. Historically, the era of conventional open surgery was characterized by the use of large forceps for clamping and ligating these ligaments. However, the advent of fascial and mesenteric anatomy research has ushered in a paradigm shift. Aided by high-definition laparoscopy, colorectal surgeons have progressively clarified the fundamental anatomical structures, thereby refining surgical techniques in accordance with fascial and mesenteric anatomical principles. This study synthesizes the author's anatomical research findings to dissect the fascial and mesenteric anatomy of the ligaments pertinent to colon cancer surgery, thereby exploring their implications for surgical practice and oncological outcomes. The gastrocolic ligament exhibits distinct fascial and mesenteric anatomical configurations within the omental sac and extra-omental regions. Within the omental sac, the sub-omental arch pathway emerges as a viable alternative to the paracolic approach for accessing the omental sac through the gastrocolic ligament. Conversely, in the extra-omental region, the incision of the greater omentum overlaying the space between the mesogastrium and the transverse mesocolon represents a mesenteric bridge facilitating access to this area. The incidence of nodal metastasis in the gastrocolic ligament associated with transverse colon and hepatic flexure colon cancer is notably low; nevertheless, selective dissection in high-risk patients can still provide survival benefits. The splenocolic ligament is formed by the convergence of the splenic hilum region of the mesogastrium (including the pancreatic mesentery) with the mesocolon of the splenic flexure of the colon. A natural avascular plane exists within it, and dissection along this plane can avoid encountering the branches of the left gastroepiploic artery that are typically encountered in traditional dissection routes. To date, there is no compelling evidence advocating for the resection of the splenic hilum region of the mesogastrium or the lymph nodes of the gastrocolic ligament in the context of splenic flexure colon cancer.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"898-903"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308669","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":"[Theory and practice on mesentery margin in vessel-oriented complete mesentery resection of gastric cancer].","authors":"L C Chen","doi":"10.3760/cma.j.cn441530-20240722-00254","DOIUrl":"10.3760/cma.j.cn441530-20240722-00254","url":null,"abstract":"<p><p>The concept of mesenteric anatomy has been evolving in cognition. With the continuous development of endoscopic techniques, the submicroscopic structures of many mesenteries have been gradually understood, ultimately confirming the ubiquitous presence of mesenteries in the digestive organs. Based on various domestic and foreign mesenteric anatomical theories and combined with years of clinical practice, we have summarized and proposed a new concept and theory-vascular-guided complete mesenteric resection for gastric cancer. The theoretical basis is that, from the perspective of the embryonic development of the digestive tract, the rotation of the digestive tract and its associated mesentery is always centered on blood vessels. Therefore, the supply vessels and digestive tracts and their associated mesentery are naturally connected. The mesentery is a complex structure that encompasses blood vessels, nerves, and lymphatic tissues. The blood vessels serve as the boundary of the mesentery, ensuring that the lymphatic network that drains the tumor is maximally resected. This article focuses on the complete mesenteric resection margins in gastric cancer surgery, that is, the lateral boundary of the mesentery as the vascular-supplied guided resection boundary and its mesentery, and the base boundary as the mesenteric bed. Using precise vascular guidance to define the extent of mesenteric resection will help accurately define the mesenteric margin during radical resection for different stages of gastric cancer.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"974-977"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308677","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":"[Thinking about the extent and technique of lower mediastinal lymph nodes dissection for adenocarcinoma of esophagogastric junction].","authors":"Y W Cao, X L Chen, K Yang","doi":"10.3760/cma.j.cn441530-20240710-00240","DOIUrl":"10.3760/cma.j.cn441530-20240710-00240","url":null,"abstract":"<p><p>The incidence of esophagogastric junction adenocarcinoma is increasing gradually. The surgical procedures mainly include radical resection of the primary tumor, lymph node dissection, and digestive tract reconstruction. Due to the special anatomical location of esophagogastric junction adenocarcinoma, the pattern of lymph node metastasis is not clear, and regional lymph nodes dissection especially in the lower mediastinum is still controversial, and awaits further high-quality evidence. Meanwhile, due to the special anatomical location of the lower mediastinum, it is often difficult to perform lower mediastinal lymph node dissection. How to complete the lower mediastinal lymph nodes dissection more safely and effectively is the key point for gastric cancer surgeons. In this paper, the progress, consensus, and controversy on the extent of lower mediastinal lymph nodes dissection in patients with esophagogastric junction adenocarcinoma were discussed. Based on our own experience, the current clinically techniques for lower mediastinal lymph nodes dissection were summarized to further improve the quality control of lower mediastinal lymph nodes dissection in patients with esophagogastric junction adenocarcinoma.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"909-913"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308678","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":"[Peripheral blood cell count composite score as a prognostic factor in patients with colorectal cancer].","authors":"P Y Guo, X H Hu, B K Li, T Lu, J M Liu, C Y Wang, W B Niu, G Y Wang, B Yu","doi":"10.3760/cma.j.cn441530-20231029-00151","DOIUrl":"10.3760/cma.j.cn441530-20231029-00151","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To develop a prognostic prediction model for patients with colorectal cancer based on a peripheral blood cell composite score (PBCS) system. &lt;b&gt;Methods:&lt;/b&gt; This retrospective observational study included patients who had primary colorectal cancer without distant metastasis, who did not undergo radiotherapy or chemotherapy before surgery, who did not receive leukocyte or platelet-raising therapy within 1 month before surgery, and whose postoperative pathology confirmed colorectal adenocarcinoma with complete tumor resection. Patients with severe anemia, infection, or hematologic diseases before surgery, as well as those with severe heart, lung, or other important organ diseases or concurrent malignant tumors, were excluded. In total, 1021 patients with colorectal cancer who underwent surgical treatment in the Department of Gastrointestinal Surgery of the Fourth Hospital of Hebei Medical University from April 2018 to April 2020 were retrospectively included as the training set (766 patients) and the internal validation set (255 patients). Additionally, using the same criteria, 215 patients with colorectal cancer who underwent surgical treatment in another treatment group from March 2015 to December 2020 were selected as the external validation set. The \"surv_cutpoint\" function in R software was used to analyze the optimal cut-off values of neutrophils, lymphocytes, and platelets, and a PBCS system was established based on the optimal cut-off values. The scoring rules of the PBCS system were as follows: Neutrophils and platelets below the optimal cut-off value = 1 point, otherwise 0 points; Lymphocytes above the optimal cut-off value = 1 point, otherwise 0 points. The scores of the three cell types were added together to obtain the PBCS. Univariate and multivariate Cox regression analyses were performed to explore the correlation between patients' clinicopathological features and prognosis, and a nomogram was constructed based on the Cox regression analysis to predict patients' prognosis. The accuracy of the nomogram prediction model was validated using the C-index, calibration curve, and decision curve analysis. &lt;b&gt;Results:&lt;/b&gt; The optimal cut-off values for neutrophils, lymphocytes, and platelets were 4.40×10&lt;sup&gt;9&lt;/sup&gt;/L, 1.41×10&lt;sup&gt;9&lt;/sup&gt;/L, and 355×10&lt;sup&gt;9&lt;/sup&gt;/L, respectively. The patients were divided into high and low groups according to the optimal cut-off values of these cells. Survival curve analysis showed that a high lymphocyte count (training set: &lt;i&gt;P&lt;/i&gt;=0.042, internal validation: &lt;i&gt;P&lt;/i&gt;=0.010, external validation: &lt;i&gt;P&lt;/i&gt;=0.029), low neutrophil count (training set: &lt;i&gt;P&lt;/i&gt;=0.035, internal validation: &lt;i&gt;P&lt;/i&gt;=0.001, external validation: &lt;i&gt;P&lt;/i&gt;=0.024), and low platelet count (training set: &lt;i&gt;P&lt;/i&gt;=0.041, internal validation: &lt;i&gt;P&lt;/i&gt;=0.030, external validation: &lt;i&gt;P&lt;/i&gt;=0.024) were associated with prolonged overall survival (OS), with statistically significant differences in all cases. Survival a","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"953-965"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308674","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}