Coloproctology

I. Overview of the Discipline

For many years, the Department of Colorectal Surgery of the Affiliated Hospital of Qingdao University has been dedicated to basic and clinical research on colorectal diseases. It shoulders the important responsibility of providing treatment, screening, prevention and control, and clinical research for colorectal diseases among the people of the Jiaodong Peninsula and even throughout the province. After years of unremitting effort, it has developed into a specialized department integrating medical care, education, research, and preventive healthcare, with the diagnosis and treatment of colorectal diseases as its specialty. It has become a medical care, healthcare, teaching, scientific research, and talent-training center for colorectal diseases in Shandong Province. Since its establishment, adhering to the concept of promoting the characteristics and advantages of traditional medicine, actively adopting new technologies in modern medicine, integrating traditional Chinese and Western medicine, and pursuing comprehensive development, the department has established a modern clinical colorectal discipline system and academic team with distinctive characteristics and strong capabilities. Its specialized technology is at the leading level in the same field in China.

The department currently has 3 wards in Huangdao, Songshan, and Pingdu, with more than 150 beds and more than 5,000 surgical patients treated annually. Focusing on common, frequently occurring, and difficult diseases of the colon, rectum, and anus, the department inherits traditional advantages, follows the development of modern medicine, and adheres to the principle of integrating traditional Chinese and Western medicine. It has gradually developed a colorectal disease diagnosis and treatment system featuring integrated traditional Chinese and Western medicine. In 2008 and 2011, it was selected as a “Specialized Department of the Qingdao Medical and Health Industry”; in 2011, it was awarded the titles of “National Colorectal Surgery Operation Observation and Exchange Center,” “National Hemorrhoid Care Center,” and “Shandong Branch of the National Continuing Education College of Colorectal Surgery”; in 2012 and 2021, it was rated as a “Key Specialized Department of Shandong Province”; and in 2016, it was rated as a “Key Specialized Department of Traditional Chinese Medicine of the Fourth Batch of Shandong Province.” As a member institution of the “National Traditional Chinese Medicine Medical Technology Collaboration Group,” it participated in the formulation, validation, and promotion of clinical pathways and diagnosis and treatment protocols for rectal prolapse, ulcerative colitis, mixed hemorrhoids, high anal fistula, and other diseases. With the approval of the competent authorities, and on the basis of the original Department of Colorectal Surgery of the Affiliated Hospital of Qingdao University, relevant disciplines and specialties were integrated to establish the “Qingdao University Medical Group Colorectal Hospital.”

II. Talent Structure

The Department of Colorectal Surgery brings together numerous outstanding professionals. Centered on master’s supervisors, the discipline is composed of a group of highly qualified young and middle-aged technical professionals. The team covers all relevant specialties and possesses high-level clinical, teaching, and research capabilities. The department currently has 1 chief physician, 3 associate chief physicians, 9 attending physicians, and 2 resident physicians. Among them, 8 hold doctoral degrees, 7 hold master’s degrees, and 4 serve as master’s supervisors. The academic leaders possess profound academic expertise and outstanding achievements in the diagnosis and treatment of colorectal diseases and are capable of leading the discipline toward its established goals.

The talent structure of the Department of Colorectal Surgery is well-balanced, with complementary academic strengths, and its diagnostic and treatment standards are continuously updated and improved. It has accumulated extensive experience in scientific research and teaching. This high-level clinical, research, and teaching team provides solid support for the hospital’s clinical diagnosis and treatment, the implementation of scientific research and teaching, and the construction and development of the discipline.

III. Professional Features

(1) Equal Emphasis on Traditional Chinese and Western Medicine

The Department of Colorectal Surgery inherits the unique advantages of traditional Chinese medicine in the prevention and treatment of colorectal diseases and actively draws on research achievements in the diagnosis and treatment of colorectal diseases at home and abroad. It has perfectly combined the essence of traditional Chinese medical treatment for colorectal diseases with the most advanced modern medical technologies, creating distinctive therapies with high efficacy, good results, and minimal discomfort. It has developed five categories of purely traditional Chinese medicine washes for the treatment of mixed hemorrhoids, anal fissure, perianal eczema, ulcerative colitis, and postoperative colorectal diseases, namely “Colorectal Washes I–V.” The distinctive traditional Chinese medicine washes apply the medicinal and thermal effects directly to the affected area, dredging the interstices, clearing heat and promoting diuresis, and regulating and harmonizing qi and blood, with excellent clinical results. The combination of acupuncture and medication, together with irrigation, is used to treat ulcerative colitis and has achieved good therapeutic results. Sacral nerve electrical stimulation is a minimally invasive treatment method with satisfactory efficacy and clinical feasibility, suitable for patients with defecation disorders who have no structural changes in the sphincter and have not responded to conservative treatment. Combining sacral nerve stimulation with traditional acupuncture to treat pelvic floor dysfunction syndrome, functional constipation, and other diseases not only greatly relieves patients’ suffering but also provides new treatment methods for difficult colorectal diseases such as pelvic floor dysfunction syndrome and functional constipation.

(2) Minimally Invasive Colorectal Concept

The development of surgery is a process progressing from invasive surgery toward minimally invasive and even noninvasive surgery. The Department of Colorectal Surgery follows the treatment principles of “minimally invasive sphincter preservation, maximum safety, and optimal suitability,” and customizes individualized treatment plans for every patient. The department currently performs the Altemeier procedure (perineal rectosigmoidectomy) and the Delorme procedure (perineal rectal mucosal sleeve resection with muscular plication) for rectal prolapse via the perineal approach; treatment of presacral cysts via the transsacral approach; primary closure procedures for pilonidal cysts, including the Karidakis flap, Limberg flap, V-Y advancement flap, and Bascom cleft lift; transanal advancement flap treatment for rectovaginal fistula; perineoplasty and anal sphincter repair for perineal lacerations via the perineal approach; the LIFT procedure (ligation of the intersphincteric fistula tract), endorectal mucosal advancement flap, and modified Hanley procedure for anal fistula; the Torpis procedure for intersphincteric and perianal abscesses; the TEM procedure for intestinal masses (three-dimensional endorectal ultrasound combined with transanal endoscopic microsurgery (); the TST procedure (selective stapled hemorrhoidopexy), PPH procedure (stapled hemorrhoidal mucosectomy), and RPH procedure (automatic hemorrhoid band ligation) for hemorrhoids; conformal suturing to reduce the area of perianal surgical wounds and accelerate wound recovery; and the use of PRP (platelet-rich plasma) to treat difficult-to-heal perianal wounds, opening up the era of minimally invasive colorectal procedures and enhanced-recovery colorectal surgery.

(3) Painless Surgery Concept

Postoperative pain in patients with colorectal diseases seriously affects postoperative recovery and quality of life. To effectively relieve postoperative pain, the department’s experts have conducted highly effective research on postoperative pain after colorectal disease surgery, proposed new analgesic concepts and methods, achieved good results in clinical practice, and promoted them nationwide.

Preemptive analgesia model: this refers to blocking nociceptive sensation before surgery to achieve postoperative analgesia or reduce pain. The assessment of preemptive analgesia includes two aspects: (1) using analgesics before the onset of pain can produce more effective analgesia than using analgesics after pain occurs; (2) using analgesics before surgery can reduce pain during the secondary phase. For example, if a patient is given analgesics before surgery, the analgesic effect reaches its peak intraoperatively, which can reduce the patient’s tension during and after surgery, and postoperative pain is significantly reduced; when a long-acting analgesic is administered during surgery, the analgesic effect can be maintained for 3–5 days; postoperative pain in colorectal patients is mainly concentrated during defecation and dressing changes. Administering analgesics before defecation and before dressing changes can effectively reduce pain, and the preemptive analgesic effect is good.

Multimodal complementary analgesia: this involves combining analgesics with different mechanisms of action or different analgesic methods to produce analgesia through multiple mechanisms, thereby obtaining better analgesic effects while minimizing complications or side effects. For example, several different analgesics may be used in combination; the same analgesic may be combined with different routes of administration; the same analgesic may be administered at different times; peripheral and central nervous system analgesia may be combined; or traditional Chinese and Western medicines may be used together. These approaches can achieve complementary or synergistic effects between medications, producing optimal analgesia and reducing adverse reactions.

IV. Scientific Research and Teaching

As a clinical master’s degree program of Qingdao University, the Department of Colorectal Surgery also undertakes teaching for nursing, undergraduate, graduate, and international students of the Medical College of Qingdao University. The department emphasizes continuing education for young physicians, strengthens “three basics and three stricts” training, and focuses on integrating theoretical knowledge with clinical practice. The department has hosted national academic conferences for many consecutive years, enabling it to keep abreast of the latest domestic and international developments in its specialty and related disciplines, and has received unanimous praise from experts and scholars at home and abroad.

The department attaches importance to scientific research and focuses on strengthening research awareness and promoting the development of the discipline through scientific research. As a member institution of the “National Traditional Chinese Medicine Medical Technology Collaboration Group,” it participated in the formulation, validation, and promotion of domestic clinical pathways and diagnosis and treatment protocols for rectal prolapse, ulcerative colitis, mixed hemorrhoids, high anal fistula, and other diseases, contributing to the standardization of colorectal disease diagnosis and treatment. The department has completed and is conducting 2 National Natural Science Foundation projects and more than 10 provincial- and ministerial-level scientific research projects, has obtained more than 10 national invention patents, has authored or co-authored more than 30 works, including “Surgery Combining Traditional Chinese and Western Medicine,” “Diagnosis and Treatment of Colorectal Diseases Combining Traditional Chinese and Western Medicine,” and “Atlas of Common Colorectal Diseases,” and has published more than 100 academic papers, including more than 10 SCI papers, providing a solid theoretical foundation for the development and improvement of clinical work.

V. Guide to Medical Visits

(1) Department Location

Outpatient clinics: Shinan Campus: 3rd floor, Outpatient Building

West Coast Campus: 3rd floor, Outpatient Building

Laoshan Campus: 2nd floor, Outpatient Building

Pingdu Campus: 2nd floor, Outpatient Building

Inpatient wards: Songshan Campus: Songshan Hospital, 3rd and 4th floors of the Inpatient Department

Huangdao Campus: 20th floor, Block A of the Inpatient Department

Pingdu Campus: 7th floor, Inpatient Building No. 2