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The application and development of laparoscopic surgery for gastric cancer has experienced a history of more than two decades, from exploratory development to clinical validation, and then to large-scale clinical studies. Gra-dually, laparoscopic gastric cancer surgery has been supported by high-level evidence. Laparoscopic surgery is progressively recommended as one of the alternative treatment for gastric cancer and is widely performed in gastric cancer surgery worldwide, especially in East Asia, such as Japan, Korea and China. Single-port and reduced-port laparoscopic surgery was first performed for cholecystectomy and appendectomy, is becoming more popular among gastrointestinal surgeons due to its minimally invasive outcomes and better cosmetic effects. However, the clinical application of single-port and reduced-port laparoscopic surgery for gastric cancer is still in the exploratory stage. The results of initially observational studies have shown that single-port and reduced-port laparoscopic surgery have potential advantages in terms of cosmetic results and enhanced recovery after surgery compared with the conventional five-port laparoscopic surgery for gastric cancer. But its surgical safety and feasibility are still not confirmed by high-level evidence of evidence-based medicine.

Since 1993, the first laparoscopic radical surgery for colon cancer was carried out in China, laparoscopic colorectal surgery in China has embarked on a new journey, and has now entered its 30th year. Looking back on the 30 years history of laparoscopic colorectal surgery, it is hoped that through the window of laparoscopic colorectal surgery, from the establishment of a series of key technologies in its initial stage, to the development of training systems, and even the further development of innovative technologies and technology platforms, to review the trajectory in the development of laparoscopic surgery in China, and to think from multiple dimensions, so as to gain experience, guide current practice, and look forward to the future development.

Cetuximab is one of the most valuable targeted therapy monoclonal antibodies in the treatment of metastatic colorectal cancer (CRC). However, the mechanisms affecting cetuximab resistance in CRC treatment remain unclear. Metabolism, especially fatty acid metabolism, has been reported to play an important role in tumor treatment. The correlation between cetuximab resistance and metabolism and whether it can be a new biomarker to evaluate the sensitivity of cetuximab in CRC treatment still need to be further explored. In this study, we perform a comprehensive analysis to confirm the relationship between fatty acid metabolism and cetuximab resistance, and the differentially expressed genes (DEGs) related to cetuximab drug resistance in CRC are screened by bioinformatics technology. We find that acetyl-CoA carboxylase beta (ACACB), ADH1C, CES1, MGLL, FMO5, and GPT are the hub DEGs, and ACACB is the most important biomarker among them. In addition, we systematically analyze the role of ACACB in the tumorigenesis of CRC, including tissue expression, CRC cell growth, cetuximab sensitivity, and potential downstream pathways, by using bioinformatics techniques, in vitro experiments and clinical cohort validation. Our results confirm that cetuximab resistance is correlated with metabolism. ACACB can lead to decreased sensitivity to cetuximab in CRC, and its mechanism may be related to EGFR phosphorylation, which could affect the activation of the mTOR/Akt signaling pathway and regulation of CDT1-, cyclin D1-, and p21-related cell cycle modulation.

Rectal cancer is common in digestive system malignant tumors. The effect of surgical treatment for patients with rectal cancer is influenced by the anatomical characteristics of pelvis. Narrow pelvic space increases the difficulty in surgery and the incidence of postoperative complications including anastomotic leakage. The study on difficulty in rectal cancer surgery due to pelvic anatomy and risk factors for postoperative anastomotic leakage was reviewed in this article.

Surgical resection is one of the main steps in the treatment of locally advanced rectal cancer. With the popularization of total mesorectal resection and laparoscopic minimally invasive techniques, related current research on surgical treatment has now entered a relatively high-level stage. In this article, we review the research frontiers of surgical treatment on rectal cancer, including reduction of trocars, specimen retrieval through natural orifices, robotic surgery, high definition/3D/indocyanine fluorescence green surgery, surgical approach and key surgery technology. Based on the current environment of evidence-based medicine, colorectal surgeons should adapt to the changes of the times, actively absorb cutting-edge scientific concepts and technologies and integrate them with surgical equipment and instruments, and carry out rigorous and innovative large-scale prospective clinical trials.

Objective To investigate pathologic effects combined with postoperative results on right colon cancer with laparoscopic complete mesocolic excision(CME) via dorsal-medial hybrid approach compared with traditional medial approach. Methods A total of 68 patients with right colon cancer undergoing laparoscopic CME in our hospital between Ja-nuary and June 2017 were studied retrospectively. There were two groups including 37 cases in dorsal-medial hybrid group and 31 cases in traditional medial group. CME quality evaluated with the method proposed by West et al along with safety, short-term results and long-term prognosis were compared between two groups. Results CME completion rate was 86.5% in dorsal-medial hybrid group and 80.6% in traditional medial group without statistical difference(P=0.53). Laparoscopic dissection time in dorsal-medial group was significantly shorter than that in traditional medial group[(62.70±12.22) min vs.(70.39±11.98) min, P=0.01]. There was no statistical difference in operation time, blood loss, postoperative flatus time, postoperative complications and long-term prognosis of the patients between two groups. Conclusions Laparoscopic CME via dorsal-medial hybrid approach for right colon cancer could have less laparoscopic dissection time, and two approaches were similar in CME quality, safety and prognosis.

Objective To compare two approaches of single-stage of treating concomitant gallbladder stones and common bile duct stones. Laparoscopic cholecystectomy (LC) was performed with endoscopic retrograde cholangiography (ERCP) as ERCP group and LC combined with laparoscopic common bile duct exploration (LCBDE) as LCBDE group. Intraoperative ERCP was compared with LCBDE. Methods Retrospective analysis was performed for 189 patients with concomitant gallbladder stones and common bile duct stones in our hospital from January 2017 to December 2018. A total of 111 cases were in ERCP group using LC with ERCP and 78 cases in LCBDE group using LC with LCBDE. The efficacy, safety and economy of two approaches were investigated. Results No statistical significance was present between two groups in gender, age, BMI, ASA grade, and preoperative examination (P>0.05). Significant difference was not found in stone clearance rate and postoperative complications(P>0.05). The cases in LCBDE group had wider indication with more patients of gastric surgery history and larger stones. The cases in ERCP group had less hospital days (6.79±2.78 d vs. 13.18±5.43 d, P