Qiantong Dong

Robotic surgery is a well-validated treatment option for colorectal cancer (CRC). We aimed to evaluate the efficacy and safety of the Weigao (WG) robotic system compared with those of the da Vinci (DV) platform for the surgical resection of CRC. We retrospectively analyzed patients with stage I-III CRC who underwent robotic CRC resection using the Weigao or da Vinci Surgical System. Statistical analysis of perioperative clinical data, including preoperative, intraoperative, and postoperative parameters was conducted. A total of 103 patients were included and divided into the WG (n = 65) and DV (n = 38) groups. All patients achieved surgical success, and there were no significant differences in preoperative baseline characteristics. However, the WG group demonstrated a significantly longer operative time. Patients in the WG group experienced a shorter time to first flatus and a low incidence of postoperative deep vein thrombosis. Notably, the total hospitalization cost was significantly lower when the Weigao Surgical System was used. This study demonstrated that the Weigao robotic system was comparable to the da Vinci system in terms of safety and efficacy for CRC surgery. Moreover, the total hospitalization cost was significantly reduced with the Weigao Surgical System, highlighting its potential as a cost-effective surgical option.

Background: Personalized nutritional management during cancer remains challenging in clinical practice. The development of an electronic patient-reported outcome platform (ePROM) provides novel opportunities. Objective: This study aimed to evaluate the effectiveness and adherence of nutritional management using ePROM in patients with cancer. Methods: This multicenter prospective longitudinal cohort study included 6124 patients diagnosed with cancer. Exposure was defined as adherence to the ePROM journal, measured by the longest consecutive month of weekly entries. Dietary intake was reported via food selection, voice input, or meal photos. The primary outcomes were adequate energy intake (EI, ≥25 kcal/kg/day) and protein intake (PI, ≥1 g/kg/day), defined according to European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines. Logistic regression analysis was conducted to identify the factors associated with EI and PI, reporting odds ratios (ORs) and 95% CIs. A restricted cubic spline plot was used to illustrate the association between the adjusted ORs and adherence duration. The semMediation approach was applied to assess the impact of multiple mediators on the outcomes. Results: The study cohort comprised 3741/6124 (61.1%) men and 2383 (38.9%) women, with a median age of 60.85 (IQR 53.3-68.3) years. Overall, 1024/6124 (16.7%) and 2591/6124 (42.3%) patients achieved adequate EI and PI scores, respectively. At one month, 499/1024 patients (48.7%) in the adequate EI group and 1287/2591 (49.7%) in the adequate PI group continued journaling, compared with 1879/5100 (36.8%) and 1091/3533 (30.9%) in the corresponding inadequate groups ( P <.001). This trend remained significant in the second, third, and sixth months. Logistic regression analysis demonstrated that longer adherence to ePROM journaling was independently associated with adequate EI (OR 1.05, 95% CI 1.01‐1.08; P =.01) and PI (OR 1.22, 95% CI 1.16‐1.28; P <.001) after adjusting for confounders. Mediation analysis revealed that most symptoms did not significantly mediate these effects, except for constipation, reflux, and delirium, which showed statistical significance but minimal indirect effects. Conclusions: Nutritional management via ePROM is a feasible approach, with improved effectiveness as adherence duration increases. The observed benefits resulted primarily from direct effects rather than from symptom improvement.

Purpose To compare perioperative outcomes and safety between the novel single-port robotic systems (SPRS) and the da Vinci Xi robotic system (DVRS) in radical colorectal cancer resection. Methods In this retrospective cohort study, 59 patients who underwent curative colorectal resection were assigned to either the SPRS group (n = 21) or the DVRS group (n = 38). Intraoperative metrics, postoperative recovery parameters, and complications were compared between groups. Results All procedures were successfully completed without open conversion and the number of lymph nodes harvested was comparable. The SPRS group demonstrated significantly longer operative times (298.86 ± 76.08 min vs. 227.84 ± 70.20 min; p < 0.001). No significant differences were observed in estimated blood loss, time of gastrointestinal recovery(first flatus), time of dietary resumption (liquid/soft diet), or 30-day readmission rates (p > 0.05). The DVRS group exhibited prolonged median postoperative hospitalization (10.00 days [IQR 8.00–11.75] vs. 8.00 days [IQR 7.00–9.00]; p < 0.05). Patients in the SPRS group reported significantly higher satisfaction scores regarding the cosmetic appearance of postoperative scars compared to those in the DVRS group(7.71 ± 1.01 vs. 6.66 ± 0.91; p < 0.001). Complication rates showed no statistical difference (p > 0.05). All complications were Clavien-Dindo grade I–II managed conservatively, except one SPRS case requiring endoscopic intervention for grade IIIa gastrointestinal hemorrhage. Conclusions The novel single-port robotic systems are safe and feasible for radical colorectal cancer surgery. They achieve short-term outcomes comparable to the da Vinci Xi system, with the advantages of a shorter hospitalization and better cosmetic outcomes but at the expense of a longer operative time.

Background: The Weigao surgical robot system (WG-NST600S) was successfully developed in China. In this study, we presented our single-center experience and the short-term outcomes of gastrointestinal surgeries performed using the WG-NST600S system. Materials and Methods: Between April 2024 and February 2025, consecutive gastrointestinal surgeries were performed using the WG-NST600S system at the participating institution. Clinical characteristics, as well as surgical and short-term postoperative outcomes, were prospectively collected and analyzed. Results: One hundred and six patients were enrolled in the study. Of these, 9 underwent radical gastrectomy, 16 partial gastrectomy, 58 radical resections for rectal cancer, 7 sigmoidectomy, 5 left hemicolectomy, and 11 right hemicolectomy. The median operative times were as follows: 278 min for radical gastrectomy, 137 min for partial gastrectomy, 245.5 min for radical resection of rectal cancer, 242 min for sigmoidectomy, 290 min for left hemicolectomy, and 311 min for right hemicolectomy. The blood loss was 20 mL for radical gastrectomy, 10 mL for partial gastrectomy, 20 mL for radical resection of rectal cancer, 20 mL for sigmoidectomy, 25 mL for left hemicolectomy, and 20 mL for right hemicolectomy. Postoperative complications were 22.22% for radical gastrectomy, 6.25% for partial gastrectomy, 18.97% for radical resection of rectal cancer, 42.86% for sigmoidectomy, 0% for left hemicolectomy, and 27.27% for right hemicolectomy. All procedures were successfully completed without conversion to open surgery or other unplanned interventions. Conclusion: Based on our single-center experience, the WG-NST600S system is a feasible, safe, and effective option for most gastrointestinal surgeries.

Ferroptosis is a newly discovered type of regulated cell death, characterized by the iron-dependent accumulation of lipid reactive oxygen species, which has been implicated in a number of human diseases. However, the regulatory mechanisms underlying ferroptosis in colorectal cancer (CRC) remain unclear. In this study, we unravel the pivotal role of PRMT5 in the progression of CRC by promoting ferroptosis resistance. Mechanistically, PRMT5 directly inhibits the transcription of m⁶A demethylase ALKBH5 via histone modifications (H4R3me2s and H3R8me2s), bolstering SLC7A11 mRNA stability and expression, thereby aggravating CRC progression through attenuating ferroptosis. Particularly, our work identifies PRMT5 as a novel lactylation substrate at lysine 240 (PRMT5 K240lac), crucial for sustaining CRC ferroptosis resistance by shaping the ALKBH5/SLC7A11 axis, while mutation disrupting these effects. Overall, our work underscores the significance of PRMT5 K240lac in conferring ferroptosis resistance in CRC, proposing targeted intervention along the PRMT5 K240lac/ALKBH5/SLC7A11 axis as an innovative therapeutic approach in CRC treatment.

Background: Survival prognosis of patients with gastric cancer (GC) often influences physicians’ choice of their follow-up treatment. This study aimed to develop a positron emission tomography (PET)-based radiomics model combined with clinical tumor-node-metastasis (TNM) staging to predict overall survival (OS) in patients with GC. Methods: We reviewed the clinical information of a total of 327 patients with pathological confirmation of GC undergoing 18 F-fluorodeoxyglucose (18 F-FDG) PET scans. The patients were randomly classified into training (n = 229) and validation (n = 98) cohorts. We extracted 171 PET radiomics features from the PET images and determined the PET radiomics scores (RS) using the least absolute shrinkage and selection operator (LASSO) and random survival forest (RSF). A radiomics model, including PET RS and clinical TNM staging, was constructed to predict the OS of patients with GC. This model was evaluated for discrimination, calibration, and clinical usefulness. Results: On multivariate COX regression analysis, the difference between age, carcinoembryonic antigen (CEA), clinical TNM, and PET RS in GC patients was statistically significant (p < 0.05). A radiomics model was developed based on the results of COX regression. The model had the Harrell’s concordance index (C-index) of 0.817 in the training cohort and 0.707 in the validation cohort and performed better than a single clinical model and a model with clinical features combined with clinical TNM staging. Further analyses showed higher PET RS in patients who were older (p < 0.001) and those who had elevated CEA (p < 0.001) and higher clinical TNM (p < 0.001). At different clinical TNM stages, a higher PET RS was associated with a worse survival prognosis. Conclusions: Radiomics models based on PET RS, clinical TNM, and clinical features may provide new tools for predicting OS in patients with GC.

Sarcopenia, overweight and obesity are all dynamic changes in body composition, which may have a negative effect on the prognosis for patients with colorectal cancer. The aim of this study was to investigate the predictive role of sarcopenia on overweight or obese patients with colorectal cancer. We conducted an observative study on the population of overweight or obese patients with colorectal cancer who underwent curative surgeries in two centers between 2015 and 2021. They were grouped by the presence of sarcopenia. Propensity score match analysis was used to balance the baseline of clinicopathologic characteristics of the two groups. Then, the postoperative outcomes between the two groups were compared. Independent risk factors were evaluated for complications using univariate and multivariate analysis. Of 827 patients enrolled, 126 patients were matched for analysis. Patients with sarcopenia had a higher incidence of total complication and medical complications, a higher rate of laparoscopic surgery performed and higher hospitalization costs. Old age (≥65 years, P = 0.012), ASA grade (III, P = 0.008) and sarcopenia (P = 0.036) were independent risk factors for total complications. ASA grade (III, P = 0.002) and sarcopenia (P = 0.017) were independent risk factors for medical complications. Sarcopenia was prevalent among overweight or obese patients with colorectal cancer and was associated with negative postoperative outcomes. Early recognition of changes in body composition could help surgeons be well prepared for surgical treatment for overweight or obese patients.