Hospital schedule
Why does complex colorectal cancer need a multidisciplinary review before surgery?
When colorectal cancer is accompanied by a blood clot, liver metastases or involvement of nearby organs, the team discusses what to treat first, how to sequence care for each site and which specialists should take part.
Rectal cancer and a leg clot in an older patient
A 96-year-old patient was found to have a deep vein thrombosis in the leg before rectal cancer surgery. Gastrointestinal surgery, vascular surgery, anaesthesia and critical care assessed pulmonary embolism risk and whether the patient could tolerate surgery. An inferior vena cava filter was placed before Dr Jiagang Han’s team performed laparoscopic rectal cancer resection at lower insufflation pressure. The operation took about 2 hours, with about 10 mL of blood loss. The patient met discharge criteria one week later. Clot management and surgical suitability depend on individual risk.
Liver metastasis found at diagnosis
A 67-year-old patient had rectal adenocarcinoma and a metastasis in liver segment 7. Gastrointestinal surgery, hepatobiliary surgery, oncology and imaging reviewed the case. After 4 cycles of chemotherapy with immunotherapy, the team reassessed the patient. In the same operation, Dr Han’s team removed the rectal tumour and Dr Hua Fan’s team removed the liver lesion. The liver team converted from laparoscopy to open surgery because the lesion lay close to major vessels and posed a bleeding risk. Surgery lasted over 7 hours. Both specimens had tumour-free margins and the patient went home. The margin findings apply to those specimens.
Sigmoid colon cancer with a fistula to the bladder
In a 70-year-old patient, locally advanced sigmoid cancer formed an abnormal passage into the bladder. Once the urinary infection was controlled, Dr Han convened a joint review. Gastrointestinal surgeons removed the tumour and rejoined the bowel in the same operation. Urologists removed and repaired the affected bladder wall, and gynaecologists removed the uterus and both adnexa. The patient went home without a bowel stoma or serious postoperative problems. A joint review can clarify each team’s role and how plans may change if surgery reveals something unexpected.
What families can bring
Gather pathology and colonoscopy reports, recent scan files and reports, a treatment summary and a list of other conditions and current medicines. Ask which specialists may need to take part, what treatment sequences are possible and what might change the plan. SinoCareHub can help prepare a bilingual medical summary and communicate the request for a joint review. The treating team decides on care.
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