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Cohort studies

Project 1: Health technology assessment (HTA) of robot-assisted surgery versus laporascopic and open surgery for middle and low rectal cancer

Robot-assisted surgery is a significant advancement in clinical surgery. Laparoscopic surgical robots have been widely used in clinical fields, particularly in colorectal cancer surgery. Compared to traditional surgical methods, robot-assisted surgery has the advantages of clearer vision and more precise operation, albeit at a higher cost. Colorectal cancer is one of the most common malignant tumors of the digestive tract in China. To date, low anterior resection is the most widely performed sphincter-preserving operation. This study intends to establish a national multicenter observational cohort to to compare the cost-effectiveness of robot-assisted to traditional laparoscopic/open surgery. Additional objectives include comparing the impact of different surgical techniques on perioperative clinical indicators, oncological outcomes, survival rates, quality of life, preoperative anxiety, and financial burden. The study aims to clarify the clinical and economic value of robot-assisted surgery in radical low anterior resection for middle and low rectal cancer from a social perspective.

Introduction of the project team

Leading clinical institution: The Sixth Affiliated Hospital, Sun Yat-sen University

(https://www.zs6y.com/page/web/pc/index.html#/HospitalTraining/127)

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The Sixth Affiliated Hospital, Sun Yat-sen University is a tertiary-level hospital integrating medical treatment, teaching, research, preventive care, and rehabilitation. It is one of the ten hospitals directly affiliated with Sun Yat-sen University and consists of two campuses: the Yuancun Headquarters in the Financial City and the Shougouling North Campus. The hospital is equipped with 1,202 beds with 1,463 available.  It is classified as a “AAA Hospital,” the highest tier in the social medical insurance system of Guangzhou. It is a designated hospital for medical insurance in Guangzhou, settlements through the intra-provincial medical treatment network in Guangdong Province and national inter-provincial medical insurance, provincial and city-level medical insurance, and district-level public medical services.

As of March 2022, the hospital has a total of 2,420 staff including2,174 professional and technical personnel, 2,031 healthcare professionals. 192 senior title holder, 64 doctoral supervisors, and 114 master's supervisors. This includes a large number of clinical, scientic research and teaching professionals such as leading talents from Sun Yat-sen University's "Hundred Talents Program," experts receiving special subsidies from the State Council, young experts with outstanding contributions recognized by the National Health Commission, and leading figures from the "Southern Talent Plan" in Guangdong. The founding Director and Honorary Director, Professor WANG Jianping, has served as the head of the Colorectal and Anal Surgery Group of the Chinese Medical Association for 11 years, editor-in-chief of the "Chinese Journal of Gastrointestinal Surgery," and chief editor of the 8th and 9th editions of the undergraduate textbook  Surgery . He also headed the expert group that drafted the "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" (2010, 2015, 2017, 2020 editions) issued by the National Health Commission.

Premier Gastrointestinal and Anal Specialty Department in China

The gastrointestinal and anorectal specialty departments of the Sixth Affiliated Hospital, Sun Yat-sen University (including the gastrointestinal and anal surgery department, gastroenterology department, oncology department, and gastroenterology institute)  has 30 doctoral supervisors, 78 master's supervisors, and 58 individuals with senior title holder. It has 797 beds and possesses one of the nation’s foremost colorectal and gastric cancer consultation and treatment centers. The department also pioneered the first colorectal cancer MDT clinic, inflammatory bowel disease MDT clinic, gastric cancer MDT clinic, and constipation outpatient clinic in the South China region.

As the leading unit of the expert group, the hospital has assisted the National Health Commission in drafting the "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" (editions of 2010, 2015, 2017, and 2020). It has also served as the head of the Colorectal and Anal Surgery Group at the Chinese Medical Association, the chief editor unit of the nationally compiled textbook Surgery (8th and 9th editions), and the co-editor unit for Internal Medicine (7th edition). These roles underscore its significant contributions to standardizing gastrointestinal surgery in China. Additionally, the hospital has supported the National Health Commission and other sectors in establishing treatment standards and guidelines for inflammatory bowel diseases, hernias, hemorrhoids, fistulas, and anal fissures.


Clinical team leader, co-leader, and project manager

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Professor WANG Jianping

Professor WANG serves as the Honorary President of the Sixth Affiliated Hospital, Sun Yat-sen University, and was previously the Executive Vice-President of Sun Yat-sen University and Honorary President of the Foresea Life Guangzhou General Hospital. He holds an MD and is both a Professor and Chief Physician, as well as a Doctoral Supervisor. Professor WANG is a special subsidy recipient from the State Council, a Fellow of the American College of Surgeons, an Honorary Member of the American Society of Colon and Rectal Surgeons (ASCRS), and a Fellow of the Royal College of Surgeons of England. His leadership roles include Chairman for China under the Asia-Pacific Enterostomal Therapy Association, Honorary Leader of the Colorectal and Anal Surgery Group of the Chinese Medical Association, and Vice Chairman of the Colorectal Surgery Committee of the Chinese Medical Doctor Association. Professor WANG also contributes internationally as a member of the Japanese Society of Gastroenterological Surgery. His roles within China include serving as Vice President of the Guangdong Medical Doctor Association and Chairman of the Anorectal Branch of the Guangdong Medical Association.

In academia, he is the editor-in-chief of the Chinese Journal of Gastrointestinal Surgery and Gastroenterology Report and serves on the editorial board of Techniques in Coloproctology. He has led the expert group for the National Health Commissions "Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer" from 2010 to 2018 and has played significant editorial roles in the national medical textbook Surgery, contributing to the 5th through 9th editions. Professor Wang has also been invited to the editorial boards of the Chinese Journal of Surgery, the Chinese Journal of Practical Surgery, Cancer, and the Journal of Colorectal and Anal Surgery.

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Professor XU Jianmin

Professor XU Jianmin from Fudan Universityserves as the Director of the Colorectal Cancer Center and Colorectal Surgery Department at Zhongshan Hospital, affiliated with Fudan University. He is also the Director of the Shanghai Colorectal Tumor Minimally Invasive Engineering Technology Research Center. He holds a Doctorate in Medicine and serves as a professor, chief physician, and doctoral supervisor. Professor Xu is renowned for his expertise in both the clinical and basic research of colorectal tumors, as well as minimally invasive surgical techniques.

He is a standing committee member of the Surgical Branch of the Chinese Medical Doctor Association and serves as the Vice Chairman of CSCO. He also leads the Oncology Transfer Committee within the Coloproctology Branch. Additionally, he is a member of the Colorectal Surgery Group of the Chinese Medical Association's Surgery Branch, and the Vice Chairman for both the Colorectal Cancer Committee and the Oncology Big Data and Real-World Research Committee of the China Anti-Cancer Association. Professor XU is also designated as a young expert in national healthcare. He has been honored as a "Shanghai Craftsman" and a "Leading Talent of Shanghai," and has been acknowledged as an outstanding leader in his academic discipline.

Professor XU has published 228 papers, including 112 indexed in the Science Citation Index (SCI) with a total impact factor of 668.14, appearing in prestigious journals such as  J Clin Oncol.,  Ann Surg,  Clin Cancer Res, and Oncogene. He has edited five monographs, filed ten invention patents, and received two patent approvals. He has received numerous awards, including the second prize for National Scientific and Technological Progress, first prizes for Scientific and Technological Progress and Medical Achievements from both the Shanghai Municipal Government and the Ministry of Education, and the first prize for Medical Science and Technology from Shanghai.

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Professor CAI Sanjun 

Professor CAI Sanjun holds the esteemed position of Chief Expert of the Multidisciplinary Colorectal Cancer Team and Director of the Colorectal Cancer Diagnosis and Treatment Center at Fudan University Shanghai Cancer Center. He has a Doctorate in Medicine and is a professor, chief physician, and doctoral supervisor. He is the Chairman of the Shanghai Anti-Cancer Association Colorectal Cancer Committee, Chairman of the Shanghai Disease Control Center Colorectal Cancer Committee, Chairman of the CSCO Oncology Nutrition Committee, and Vice Chairman of the CSCO Colorectal Cancer Committee. Additionally, he serves as the Vice Chairman of the Multidisciplinary Team (MDT) Committee of the Chinese Medical Doctor Association, a member of the America’s National Comprehensive Cancer Network (NCCN) China Expert Committee, and is the surgical head for the NCCN Clinical Practice Guidelines in Oncology (Colorectal Cancer) Chinese edition.

Professor CAI specializes in the basic and clinical research of colorectal cancer, with a particular expertise in the surgical treatment of colorectal cancer. He has been the chief editor of medical texts, including "Cancer of Colorectum and Anal Canals" published by Peking University Press in 2005, and "Evidence-Based Colorectal and Anal Cancer" published by Shanghai Science and Technology Publishing House in 2015.

He has led numerous major research projects funded by the National Natural Science Foundation of China, the national 863 and 973 programs, and the Fudan 211 initiative, accumulating over 42 million RMB in research funding. Over the past five years, Professor CAI has published more than 90 medical papers, including over 70 SCI-indexed papers. His research has received multiple awards, including the Shanghai Municipal Science and Technology Second Prize and the Ministry of Education's Scientific and Technological Progress Second Prize in 2012, the Shanghai Preventive Medicine Association's Science and Technology Second Prize in 2018, and both the Outstanding Achievement Award at the Third National Famous Doctors Gala and the First Prize for Science and Education News in 2019.

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Professor WU Xiaojian 

Professor WU Xiaojian serves as the Vice President of the Sixth Affiliated Hospital, Sun Yat-sen University and is the Director of the Colorectal and Anal Surgery Department. He has a Doctorate in Medicine and holds the titles of Professor, Chief Physician, and Doctoral Supervisor. Professor WU is the next Chair of the Gastrointestinal Tumor Branch of the China Anti-Cancer Association and Vice Chairman of the Inflammatory Bowel Disease Committee of the Chinese Medical Doctor Association. He is also a member of the Gastrointestinal Surgery Group of the Chinese Medical Association's Surgery Branch, the Chairman of the Colorectal Cancer Division of the Guangdong Precision Medicine Application Association, and the Director of the Guangdong Inflammatory Bowel Disease Precision Diagnosis and Treatment Engineering Technology Research Center. Professor WU Xiaojian is primarily engaged in clinical practice and research in colorectal and anal surgery. He performs nearly 500 surgeries annually, focusing on conditions such as colorectal cancer and inflammatory bowel diseases. His surgical volume for Crohn's disease is the highest in China. As Vice Director and Head of the Department, he manages the department's operations and leads clinical and basic research in areas such as multidisciplinary treatment of colorectal cancer, comprehensive treatment of local rectal cancer recurrence, and surgical treatment of inflammatory bowel diseases.

Professor WU's main research interests include the immunological microenvironment of colorectal cancer and carcinogenesis in inflammatory bowel disease. He has led or been significantly involved in numerous national research projects under China's high-tech research and development program (863 Program), international cooperation projects, and other national research and development  projects. Over the past five years, he has published over 30 papers, including 17 SCI-indexed articles as the first author or corresponding author. Professor WU received the National Second Prize for Scientific and Technological Progress in 2016 and the First Prize for Scientific and Technological Progress from Guangdong Province in 2011. He was also named a Leading Medical Talent of Guangdong Province in 2019, an Outstanding Young Medical Talent of Guangdong Province in 2018, and received the "Good Doctor of Guangzhou" award in 2016. Further honors include being named a Lingnan Famous Doctor in 2017 and a "Powerful Young Doctor" in 2019.



National Centers

Serial number

Area

Name of Hospitals

Level

1

South China

The Sixth Affiliated Hospital, Sun Yat-sen University (leading clinical Institution)

Class A tertiary hospital

2

South China

Shenzhen People's Hospital, Second Clinical Medical College of Jinan University

Class A tertiary hospital

3

East China

Zhongshan Hospital Affiliated to Fudan University

Class A tertiary hospital

4

East China

Fudan University Shanghai Cancer Center

Class A tertiary hospital

5

East China

The First Affiliated Hospital of Nanchang University

Class A tertiary hospital

6

East China

The Affiliated Hospital of Qingdao University

Class A tertiary hospital

7

East China

Fujian Medical University Union Hospital

Class A tertiary hospital

8

Central China

The First Affiliated Hospital of Zhengzhou University

Class A tertiary hospital

9

North China

Chinese PLA General Hospital

Class A tertiary hospital

10

North China

Peking University People's Hospital

Class A tertiary hospital

11

Northeast of China

Shengjing Hospital of China Medical University

Class A tertiary hospital

12

Northeast of China

The Second Affiliated Hospital of Harbin Medical University

Class A tertiary hospital

13

West China

Xinjiang Uygur Autonomous Region People's Hospital

Class A tertiary hospital

14

West China

The First Hospital of Lanzhou University

Class A tertiary hospital

15

Southwest of China

The Southwest Hospital of AMU (Frist Affiliated Hospital)

Class A tertiary hospital

16

Southwest of China

Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences

Class A tertiary hospital