Colorectal Adenoma and Carcinoma

We aim to establish a single-cell atlas of primary adenomas, recurrent adenomas, and paired normal mucosa, identify recurrence-associated cell subpopulations and transcriptional pathways, and construct a risk prediction model for recurrence (integrating multi-omics features and clinical variables). Ultimately, we propose a panel of biomarkers that can be used to optimize follow-up strategies and guide potential microbiome-based interventions. Under the premise of meeting routine clinicopathological requirements, we will collect tissue samples from 30 patients with colorectal adenomas. Each collected adenoma sample will be divided into three equal portions for scRNA-seq, scATAC-seq, and microbiome diversity sequencing, respectively. Two years after sampling, enrolled patients will undergo follow-up colonoscopy. Those in whom adenomas are detected will be classified as the recurrence group, while those without adenomas will be classified as the non-recurrence group. Sequencing data will be jointly analyzed in conjunction with clinical medical records. The tissue specimens obtained will not affect routine diagnosis or treatment outcomes.

Robotic assisted surgery has been performed for more than two decades with good success and safety profile. However, there was only one dominating robotic surgical system available in the past which led to high cost for robotic surgery. Recently, a new robotic surgical system (Sentire Robotic Surgical System) was introduced by researchers of The Chinese University of Hong Kong (CUHK). This new robotic surgical system aims to achieve similar outcomes and standards of robotic surgery performed using the dominating system but with a significantly lower cost. The technologic innovation and development of this new robotic system is made by the Cornerstone Robotics Limited, which is based in Hong Kong. In a pilot clinical study conducted at Prince of Wales Hospital involving 55 patients, the Sentire Surgical System C1000 had demonstrated high success rate with minimal complications in patients who underwent robotic colorectal surgery. Recently, a new component of the system - the Patient Side Single Arm, is developed. It is an independent robotic arm designed for compatibility with the Sentire Surgical System, creating the hybrid surgical system known as the C1000 Ultra. The new component may enhance port placement flexibility, minimize arm collisions with the patient or operating table, and optimize docking for seamless integration into the operating room. The Patient Side Single Arm was proven by a preclinical study using cadaveric models to be safe and effective. The investigators would therefore like to conduct a prospective clinical study to evaluate the efficacy and safety of Sentire Surgical System Plus the Patient Side Single Arm in robotic colorectal surgery. The investigators believe that the results of this study will provide data to support its use for wide range of colorectal procedures with minimal access trauma, for the benefit of patients. This system will also lead to a wider range of clinical applications for minimally invasive surgery with a cost-effective model.