Gastrointestinal Surgery

1. Overview of the Discipline

Gastrointestinal Surgery is one of the first key disciplines in Qingdao, a Clinical Key Specialty of Shandong Province, and a Key Laboratory of Shandong Province (Key Laboratory of Basic and Translational Medicine of Gastrointestinal Tumors). It was among the first master’s degree authorization sites approved by the State Council, and currently is an authorization site for master’s and doctoral degree programs as well as a postdoctoral research station. It is also a department recognized as a “National Model Department for Medical Ethics” by the National Committee of the Education, Science, Culture, Health and Sports Workers’ Union of China and the General Office of the National Health and Family Planning Commission. The department’s principal members serve as members of the Colorectal Surgery Group of the Surgery Branch of the Chinese Medical Association, members of the Clinical Nutrition Group of the Surgery Branch of the Chinese Medical Association, standing members of the Chinese Society for Parenteral and Enteral Nutrition, Deputy Chairmen of the General Surgery Branch of the Shandong Medical Association, Deputy Chairmen of the Digital Medicine Branch of the Shandong Medical Association, and standing members of the Gastric Cancer Professional Committee of the Chinese Anti-Cancer Association, among other positions. The department is also an editorial board institution of the journal of the Chinese Medical Association, Chinese Medical Journal.

After the unremitting efforts of generations of general surgery experts and scholars over more than a century, the scale of Gastrointestinal Surgery has continued to expand, substantial progress has been made in discipline development, and the department has developed strong capabilities. Gastrointestinal Surgery has now established the following areas of development: “Colorectal Tumor Surgery, Gastric Tumor Surgery, Hernia and Abdominal Wall Reconstruction Surgery, Bariatric and Metabolic Surgery, Difficult and Critical Gastrointestinal Surgery (damage control and enterocutaneous fistula), and Surgery for Benign Gastrointestinal Diseases (inflammatory bowel disease and constipation).” It possesses the following distinctive technologies: “Da Vinci robotic surgery, 3D laparoscopic minimally invasive surgery, clinical nutritional support, multidisciplinary diagnosis and treatment of gastrointestinal tumors through MDT, transanal endoscopic microsurgery (TEM and TAMIS), transanal total mesorectal excision (taTME), intersphincteric ultra-low anterior resection with sphincter preservation for rectal cancer (ISR), natural orifice specimen extraction surgery for rectal cancer (NOSES), lateral lymph node dissection for low rectal cancer, bariatric and anti-metabolic surgery, comprehensive treatment of gastrointestinal fistulas, tension-free hernia repair, and comprehensive treatment of inflammatory bowel disease.” The department has participated in the preparation of treatment guidelines and consensus statements in areas including robotic surgery, laparoscopic colorectal cancer surgery, laparoscopic gastric cancer surgery, and enhanced recovery after surgery under the National Health and Family Planning Commission and the Chinese Medical Association. In particular, it conducted clinical and basic research in the field of artificial intelligence in colorectal surgery at an early stage and reached an internationally advanced level. It established the world’s first artificial intelligence platform-based preoperative assessment system for rectal cancer staging. The results were published in Disease of the Colon & Rectum, a top international journal in the field of colorectal disease, as well as in the internationally renowned academic journal Cancer Research (IF= 13.3), among others. It formulated the only four guidelines and expert consensus documents in China in the field of artificial intelligence in colorectal surgery and received the Second Prize of the Shandong Province Science and Technology Progress Award (first contributor) and the Second Prize of the National Science and Technology Progress Award (third contributor). The department leads the Gastrointestinal Surgery Research Collaborative Group of Shandong Province (GISSG) and completed a multicenter study of more than 5,000 gastrointestinal stromal tumor cases in Shandong Province, filling a gap in China. Gastrointestinal tumors are treated using international standards and individualized treatment plans. The department advocates a multidisciplinary treatment model (MDT), implements enhanced recovery (EARS) and damage control concepts, and strengthens safety and quality management for surgical patients. More than 5,800 operations are performed annually, including more than 3,500 Grade IV operations. Radical gastrectomy uses advanced, standardized robotic and laparoscopic lymph node dissection, combined with preoperative and postoperative adjuvant treatment and hyperthermic intraperitoneal chemotherapy. The results have been published in the authoritative international journal Annals of Surgery, and the overall treatment level is internationally leading. The department has presented its work repeatedly at domestic and international conferences and has been invited to speak at three consecutive World Gastric Cancer Congresses, showcasing the excellence of the Gastrointestinal Surgery Department of the Affiliated Hospital of Qingdao University on the world stage. It successfully resected a giant tumor weighing 100 kg from a patient weighing only 40 kg, setting a world record. This was reported in a special feature by China Central Television and became a model of comprehensive treatment.

The department has established friendly relationships with internationally renowned hospitals, including Massachusetts General Hospital in the United States, MD Anderson Cancer Center, the University of California, Los Angeles, the National Cancer Center of Japan in Tokyo, Fujita Health University Hospital in Japan, and Severance Hospital of Yonsei University in South Korea, and regularly conducts personnel training and academic exchanges. Under high standards, a high starting point, and strict requirements, the department’s development has always adhered to a patient-centered approach with quality as the core. It firmly upholds awareness of the brand of a century-old hospital, relieves patients’ suffering through superb medical technology and noble medical ethics, maximally meets the people’s desire for medical treatment, and benefits society and the people.

2. Talent Structure

Gastrointestinal Surgery has a strong talent base and has developed into a high-level medical, teaching, and research group with a full range of specialties, led by doctoral supervisors and supported by a large number of highly qualified young and middle-aged technical professionals. The department currently has 171 open beds and 41 physicians, including 10 chief physicians and professors and 12 associate chief physicians and associate professors. There are 12 doctoral and master’s supervisors. Faculty members serve on the editorial boards of Chinese Medical Journal, Gastric Cancer, Intelligent Medicine, International Journal of Surgery, Chinese Journal of General Surgery, Chinese Journal of Gastrointestinal Surgery, Parenteral and Enteral Nutrition, and other journals. The department’s principal clinical staff have studied abroad at Massachusetts General Hospital of Harvard University in the United States, MD Anderson Cancer Center in the United States, the University of California, Los Angeles, Hermann Memorial Hospital in the United States, the National Cancer Center of Japan, Fujita Health University Hospital in Japan, and Severance Hospital of Yonsei University in South Korea, among other institutions, and have extensive clinical experience. Professor Lu Yun, the academic leader, is a doctoral and master’s supervisor and currently serves as Deputy Dean of the Qingdao University Medical Group. He is an Expert with Outstanding Contributions of Shandong Province, a National Model for Medical Ethics, a National Renowned Physician, a member of the Colorectal Surgery Group of the Surgery Branch of the Chinese Medical Association, a representative to the 16th Qingdao Municipal People’s Congress, a Qingdao Leading Professional and Technical Talent, a renowned medical expert in Qingdao, and a senior visiting scholar at the University of Texas Health Science Center at Houston. He has long been engaged in basic and clinical research in gastrointestinal surgery, focusing on gastrointestinal tumors. He is proficient in the surgical and comprehensive treatment of various benign and malignant gastrointestinal tumors. In recognition of his outstanding work, he received the title of “National Model for Medical Ethics” in 2015, the first person in Qingdao’s history to receive this title jointly awarded by the National Committee of the Education, Science, Culture, Health and Sports Workers’ Union of China and the General Office of the National Health and Family Planning Commission. In 2017, he was named an “Expert with Outstanding Contributions of Shandong Province.” He has long been engaged in the clinical treatment of gastrointestinal tumors and has performed various laparoscopic operations and comprehensive treatments for gastrointestinal tumors. He was the first in the Jiaodong Peninsula to carry out new ultra-low rectal sphincter-preserving procedures, including transanal endoscopic microsurgery (TEM), transanal total mesorectal excision (taTME), intersphincteric ultra-low anterior resection with sphincter preservation for rectal cancer (ISR), and natural orifice specimen extraction surgery for rectal cancer (NOSES). In 2019, he received the Second Prize of the National Science and Technology Progress Award (third contributor). In 2020, a clinical study on colorectal tumor treatment received the Second Prize of the Shandong Province Science and Technology Progress Award (first contributor). He has reached an internationally leading level in the field of artificial intelligence in colorectal surgery and established the world’s first artificial intelligence platform-based preoperative assessment system for rectal cancer staging. The results were published in the top international colorectal journal Disease of the Colon & Rectum and the internationally renowned academic journal Cancer Research (IF= 13.3). In addition, he led the drafting and formulation of the only four guidelines and expert consensus documents in China in the field of artificial intelligence in colorectal surgery.

3. Scientific Research and Teaching

In recent years, the discipline has completed and is undertaking more than 10 National Natural Science Foundation projects, currently undertakes 1 national key project, more than 10 Shandong Provincial Natural Science Foundation projects, and 5 Qingdao key research projects, with cumulative research funding exceeding RMB 10 million. It has published more than 100 high-quality SCI papers and served as editor-in-chief, chief translator, or contributing editor for more than 30 monographs. The team’s research on an artificial intelligence platform-based preoperative assessment system for rectal cancer staging was published in the world’s leading colorectal journals Disease of Colon & Rectum and Cancer Research (IF=13.3), among others. The team’s research on enhanced recovery after gastric cancer surgery was published in the authoritative surgical journal Annals of Surgery (IF=8.5). An application-oriented paper on synthetic materials for abdominal wall hernia mesh was published in Advanced Functional Materials (IF=18.8). In recent years, the department has received 1 Second Prize of the China Industry-University-Research Collaboration Innovation Award (first contributor), 1 Second Prize of the Shandong Province Science and Technology Progress Award (first contributor), 3 Third Prizes of the Shandong Province Science and Technology Progress Award, 2 Second Prizes of the Shandong Medical Science and Technology Innovation Achievement Award, 2 First Prizes of the Qingdao Science and Technology Progress Award, and 3 Second Prizes of the Qingdao Science and Technology Progress Award, among other awards. It has successively established long-term, stable cooperative relationships with relevant institutions in the United States, Germany, Japan, South Korea, and other countries, and has appointed renowned scholars as visiting professors. More than 20 people have studied or visited abroad, and 3 postdoctoral researchers and more than 10 doctoral students have completed their studies and returned to China, playing an active role in the development of the discipline. In 2015, Professor Zhou Yanbing delivered a keynote speech at the main venue of the World Gastric Cancer Congress in Brazil as the only Chinese expert, showcasing the excellence of the Gastrointestinal Surgery Department of the Affiliated Hospital of Qingdao University on the world stage. In 2019, Professor Lu Yun was invited to attend the 104th Annual Clinical Congress of the American College of Surgeons in Boston and was awarded the honorary title of Fellowship of the American College of Surgeons (F. A. C. S).

As a master’s and doctoral training institution and a postdoctoral research station, the discipline undertakes the teaching of graduate students, international students, eight-year program undergraduates, and five-year program undergraduates. Each year, it trains more than 20 master’s students and more than 10 doctoral students. In recent years, the Gastrointestinal Surgery Teaching and Research Office has repeatedly been named an “Advanced Collective in Teaching” and an “Advanced Collective of Model Teachers’ Ethics.” Several members have successively been named “Outstanding Postgraduate Supervisors of Shandong Province,” “Outstanding Postgraduate Supervisors of Qingdao University,” “Outstanding Teachers of Qingdao University,” and “Models of Teachers’ Ethics of Qingdao University.” In 2016, Professor Zhou Yanbing of the department was named a “Good Teacher in the Hearts of Residents” by the National Health and Family Planning Commission.

4. Specialty Features

“Colorectal Tumor Surgery, Gastric Tumor Surgery, Hernia and Abdominal Wall Reconstruction Surgery, Bariatric and Metabolic Surgery, Difficult and Critical Gastrointestinal Surgery (damage control and enterocutaneous fistula), and Surgery for Benign Intestinal Diseases (inflammatory bowel disease and constipation), among others.”

(1) Colorectal Tumor Surgery

The department has developed three major brands: “ultra-low sphincter-preserving surgery,” “precise minimally invasive treatment,” and “multidisciplinary comprehensive diagnosis and treatment,” and performs nearly 2,000 high-quality colorectal operations every year. It performs all of the most advanced ultra-low sphincter-preserving procedures currently available domestically and internationally, both eradicating lesions and preserving anal function. Transanal endoscopic microsurgery (TEM and TAMIS) enables radical transanal resection of benign and malignant rectal tumors. The department widely performs domestically leading extreme sphincter-preserving procedures, including transanal total mesorectal excision (taTME) and intersphincteric ultra-low rectal resection (ISR). It performs natural orifice specimen extraction surgery for rectal cancer (NOSES), eliminating abdominal surgical incisions. It performs lateral lymph node dissection, providing patients with rectal cancer and lymph node metastases outside the conventional regional area with an opportunity for radical treatment. To achieve precision surgery, the independently developed “computer-assisted surgery system (CAS)” and “artificial intelligence staging and recognition system” have been applied clinically. These two technologies received the Second Prize of the National Science and Technology Progress Award (third contributor) and the Second Prize of the Shandong Province Science and Technology Progress Award (first contributor), respectively. The department drafted four domestic guidelines and expert consensus documents on artificial intelligence-based rectal cancer treatment. The results were published in the top international colorectal journal Disease of the Colon & Rectum and the internationally renowned academic journal Cancer Research (IF=13.3). It took the lead in establishing a colorectal cancer MDT team and a multidisciplinary diagnosis and treatment model, and was the first in China to carry out watch-and-wait treatment. It also established a specialized team for colorectal cancer with liver metastases, providing patients with distant metastases with an opportunity for cure.

(2) Gastric Tumor Surgery

Following the advanced concept of stage-oriented, surgery-centered multidisciplinary (MDT) comprehensive treatment and guided by enhanced recovery after surgery (ERAS) and damage control theory, the department is proficient in performing various open and minimally invasive radical gastric cancer operations, including laparoscopic and Da Vinci robotic surgery: totally laparoscopic distal gastrectomy for gastric cancer (modified triangular anastomosis in the Billroth-I method, Billroth-II+Braun anastomosis, Roux-en-Y anastomosis, and un-cut Roux-en-Y anastomosis); totally laparoscopic radical total gastrectomy (esophagojejunostomy with self-traction π anastomosis, FETE functional end-to-end anastomosis, Overlap anastomosis, and later-Overlap anastomosis); and totally laparoscopic radical proximal gastrectomy for gastric cancer (tubular gastroesophageal anastomosis and DTR double-tract anastomosis). More than 1,500 operations are performed annually, including more than 800 laparoscopic and robotic operations, placing the department at an advanced domestic level. Related research results have been published in authoritative surgical journals, including Annals of Surgery, Journal of Gastrointestinal Surgery, and Journal of Surgical Research. In addition, in response to the rising incidence of gastric stromal tumors in recent years, the department led the Gastrointestinal Surgery Research Collaborative Group of Shandong Province (GISSG) in completing a multicenter study of more than 5,000 gastrointestinal stromal tumor cases in Shandong Province, filling a gap in China. The relevant research findings were published in Annals of Surgical Oncology, Advances in Therapy, and Frontiers of Medicine, respectively.

(3) Hernia and Abdominal Wall Reconstruction Surgery

The specialty team performs more than 600 operations for various types of hernia each year. The proportion of minimally invasive procedures reaches 90%, and the average length of hospital stay is 3.2 days. The team specializes in laparoscopic minimally invasive treatment of various external abdominal hernias, including inguinal hernia, incisional hernia, umbilical hernia, lumbar hernia, parastomal hernia, and hiatal hernia; abdominal wall tumor resection and reconstruction; and treatment of various giant, complex, and difficult abdominal wall hernias using small-incision-assisted laparoscopy (hybrid technology). It achieves a high surgical success rate, low recurrence rate, and few complications, with treatment outcomes reaching an advanced domestic level. The team emphasizes the principle of “individualized treatment” and selects surgical methods and mesh according to the patient’s disease and physical condition. For example, tension-free inguinal hernia repair under local nerve block anesthesia is used for elderly and frail patients, while biological mesh is used for tension-free hernia repair in adolescent patients. The specialty team was the first in the province to carry out and promote day surgery for inguinal hernia, shortening hospital stays, reducing hospitalization costs, conserving medical resources, and reducing patients’ financial burden. This has received widespread praise from patients and produced good social benefits. The specialty team currently undertakes multiple research projects and has published several high-quality SCI papers. In the field of hernia mesh materials research, the specialty’s application-oriented paper on synthetic materials for abdominal wall hernia mesh was recently published in Advanced Functional Materials (IF=18.8).

(4) Bariatric and Metabolic Surgery

This specialty began in 2007, when it published the first domestic book on bariatric surgery, Surgery of Obesity. In 2014, it performed the first laparoscopic sleeve gastrectomy. In 2020, it established a subspecialty and multidisciplinary team outpatient clinic for bariatric and metabolic surgery. It currently has dedicated bariatric and metabolic surgeons, case managers, dietitians, and psychological counselors, and uses an MDT model for comprehensive assessment of patients’ conditions, providing patients with a comprehensive one-stop diagnosis and treatment platform. The department routinely performs laparoscopic sleeve gastrectomy, sleeve gastrectomy plus jejunojejunostomy/ileal bypass, sleeve gastrectomy plus hiatal hernia repair, and laparoscopic gastric bypass, among other procedures. More than 300 bariatric and metabolic operations have been performed in total, with approximately 100 operations annually. The department also actively promotes the enhanced recovery after surgery model, uses a three-port laparoscopic approach, and does not place a gastric tube, urinary catheter, or drainage tube. Postoperative pain is mild, and patients can get out of bed and move around on the day of surgery. Team members have introduced their experience and research findings at international and domestic conferences on multiple occasions and regularly hold national- and provincial-level academic conferences with numerous hospitals in China. The department is currently a member institution of the Obesity and Diabetes Surgery Physician Committee of the Surgical Physicians Branch of the Chinese Medical Doctor Association and a member institution of the Greater North China Bariatric and Metabolic Surgery Alliance. It also serves as a member of national-, provincial-, and municipal-level bariatric surgery-related associations. It has published 5 papers related to bariatric and metabolic surgery.

(5) Difficult and Critical Gastrointestinal Surgery (Damage Control and Enterocutaneous Fistula)

In recent years, the department has introduced and developed the advanced concept of damage control surgery. During the “Huangdao 11.22 Explosion Accident,” this concept was fully applied to begin rescue efforts in the shortest possible time after the explosion. It not only rapidly saved the lives of multiple injured persons but also completed the first surgical operation after the accident. Damage control surgery has also been introduced into the treatment of various acute abdominal conditions, saving countless lives. For complex intestinal fistulas, severe intra-abdominal infection, severe closed abdominal injury, abdominal compartment syndrome, intestinal failure, multiple trauma and combined trauma accompanied by gastrointestinal anatomical abnormalities/function impairment, various intestinal obstructions, inflammatory bowel disease, radiation-induced intestinal injury, severe acute pancreatitis, and gastrointestinal tumors with complications, among other diseases, the department has developed a complete set of theories, systems, and rules for treatment from theory through clinical practice, and is at an advanced level in China. Complex enterocutaneous fistulas are characterized by severe clinical conditions, rapid disease progression, prolonged hospitalization, high costs, and high mortality. The team of Academician Li Jieshou at the General Hospital of the Eastern Theater Command received the First Prize of the National Science and Technology Progress Award for its outstanding contributions to the treatment of intestinal fistulas. More than 20 years ago, the department established good academic exchange and cooperation with Academician Li Jieshou’s team, mastered the core theories and technologies for managing intestinal fistulas, and has repeatedly assisted sister departments and hospitals in the surrounding areas of the peninsula in treating patients with intestinal fistulas after gastrointestinal surgery, achieving good results in every case. It has also published multiple SCI papers in this field based on clinical practice.

(6) Surgery for Benign Gastrointestinal Diseases (Inflammatory Bowel Disease and Constipation)

In addition to the routine diagnosis and treatment of gastrointestinal tumors, the department also has extensive experience in the diagnosis and treatment of benign gastrointestinal diseases, mainly including inflammatory bowel disease (IBD), refractory constipation, radiation enteritis, severe gastroesophageal reflux disease, and complex intestinal fistulas. Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis. Using a multidisciplinary (MDT) diagnosis and treatment model, the department works closely with the Department of Gastroenterology, Department of Pathology, Department of Radiology, and Department of Nutrition to provide individualized diagnosis and treatment for every patient with IBD, implementing “tailored strategies for each patient” and achieving precise surgical treatment. The department is gradually carrying out surgery for Crohn’s disease, perioperative nutritional therapy, and whole-course chronic disease management. It was the first in the Jiaodong Peninsula region to attempt laparoscopic total proctocolectomy with ileal pouch-anal anastomosis (IPAA) and transanal minimally invasive surgery (TAMIS) for ulcerative colitis. It has also accumulated considerable experience in treating complex Crohn’s disease and acute severe ulcerative colitis. In addition, the department introduced and improved the Jinling procedure from the General Hospital of the Eastern Theater Command and has begun to carry out surgical treatment for refractory constipation. It has achieved significant therapeutic effects for slow-transit, outlet-obstruction, and mixed constipation. For severe gastroesophageal reflux disease, the department has successfully performed new surgical procedures in recent years, including totally laparoscopic fundoplication (Nissen and Toupet procedures). These procedures cause minimal surgical trauma and have a high cure rate, relieving the long-term suffering of many patients.

5. Patient Guide

(1) Department Locations

Outpatient Clinics:

Shinan District Campus: 6th floor of the Outpatient Building

Laoshan Campus: 2nd floor of the Outpatient Building

West Coast Campus: 2nd floor of the Outpatient Building

Pingdu Campus: 2nd floor of the Outpatient Building

Inpatient Wards:

Shinan District Campus: 4th floor of the Second Inpatient Department

Laoshan Campus: 8th floor of the Inpatient Building

West Coast Campus: 12th floor of Building A of the Inpatient Building

Pingdu Campus: 12th floor of Building 3 of the Inpatient Building

(2) Consultation Telephone Numbers

Shinan District Campus: 82911324

Laoshan Campus: 82913050

West Coast Campus: 82919521

Pingdu Campus: 8291 8612