【Tomorrow at noon】

In August 2021, when he received an email from the American Academy of Surgery to be elected as an honorary academician, Professor Fu Chuangang thought that someone was joking with him.

From October 23 to 27, the 107th Annual Meeting of the Clinical Conference of the American Academy of Surgeons, acs was held online. Professor Fu Chuangang was officially elected as an honorary academician of the American Academy of Surgeons, becoming the fifth mainland Chinese expert in the century-old history of the American Academy of Surgeons to receive this honor. The four experts in front of him are Academician Wu Yingkai, Professor Tu Guiyi, Professor Peng Shuyu and Academician Zhao Yupei.

The Honorary Fellow of the American Academy of Surgery is a high recognition of the surgeon's surgical ability and influence. The elected not only has a leading position in the professional field, but also has made outstanding contributions in medical services.

For Professor Fu Chuangang, this honor is just the icing on the cake for his long career as anorectal surgeon. Now he is standing at a new starting point in his career and is sprinting to a new height.

In 2015, Professor Fu Chuangang made an important decision: to leave Shanghai Changhai Hospital, which has been working for more than 30 years, and join the Oriental Hospital Affiliated to Tongji University.

For Professor Fu Chuangang, this is a new starting point in his career, and even the departments were newly built. Before Professor Fu Chuangang joined, Oriental Hospital had no department of colorectal anorectal surgery, and only had a gastrointestinal professional group in the Department of Gastroenterology.

Although the department was established in May 2015, it was not until August 2016 that Professor Fu Chuangang officially came to Oriental Hospital full-time after the order to retire early at Changhai Hospital, and the department development was not on track. In 2014, before Director Fu Chuangang came, the annual number of colorectal cancer in Oriental Hospital was only more than 100 cases, and now the annual number of colorectal cancer in the department has reached about 1,000.

"If you go to the ward to take a look, we basically receive intestinal cancer, and 75% of the patients are patients from other places." Professor Fu Chuangang said, "Why do patients grow so fast? They need to have medical quality and department brands. Every patient can get good medical services and the treatment effect is good. They will take the initiative to promote it, and more patients will follow."

This is not the first time Director Fu Chuangang led a department from weak to strong. As early as 2000, when Fu Chuangang took over as director of the anorectal surgery department of Changhai Hospital, the department had only two main business directions: constipation and stoma care, and other directions were very weak.

"I proposed to transform, and we should focus on the direction of colorectal cancer as the development of our discipline, and focus on low-level anal protection. Because as people's living standards improve, the incidence of colorectal cancer will become higher and higher, becoming a common disease and a major disease that affects survival and quality of life."

As soon as this direction was proposed, it was ridiculed and opposed by many old professors. "They said that I was young and energetic, and I didn't know how to protect my anus when we were so weak. It's enough for us to do what we didn't want to do. At that time, I said, we must not be like this, why do we have to eat other people's leftovers? I am very confident that we have to do high-difficulty technology."

More than 20 years later, when Professor Fu Chuangang came to Oriental Hospital and proposed to build the gastrointestinal and anorectal surgery department of Oriental Hospital into the best department in Shanghai, the doctors in the department also laughed. He cheered the team and said, "I am the chairman. I did the best in Shanghai before. Now that I am here, our team will also become the best in Shanghai."

After becoming the director, Professor Fu Chuangang proposed the "five combinations" development policy: combining the abdomen and the anus, combining malignancy and benignity, combining diagnosis and treatment, combining traditional Chinese and Western medicine, and combining clinical and scientific research.

After arriving at Oriental Hospital, based on these "five combinations", Director Fu Chuangang added another: the combination of traditional openness and laparoscopy. "We not only did laparoscopy, but also did 3D laparoscopy. I call it 'white, bloodless, extremely minimally invasive, fine and accurate, low-level anus protection, no incision', which is also the first in China."

Among them, "combination of diagnosis and treatment" is a major feature given by Director Fu Chuangang to the department that is different from other hospitals. Most anorectal surgeons in China only know how to perform surgery and do not do colonoscopy. Director Fu Chuangang personally performed colonoscopy for patients from examinations and diagnosis before treatment to follow-up after treatment. The integration of diagnosis and treatment also allowed patients to avoid running around.

Once at Changhai Hospital, the anorectal surgery department led by Director Fu Chuangang accounted for 2/3. Later, the hospital established an endoscopy center, integrating the gastroenteroscopy of the anorectal surgery and the gastroenteroscopy of the gastroenterology department. Director Fu Chuangang still maintained his independence and personally performed colonoscopy for patients, and also asked the department doctor to do so.

"I often say in the department that we must think from the perspective of others. If we are patients, we first go to the gastroenterology department, then go to the endoscopy center for gastroenteroscopy. After the examination, we found a tumor, and then transferred to the surgery department for surgery. After the surgery, then transferred to the oncology department for chemotherapy, would you find it difficult? The patient came to us and we personally did colonoscopy. After the tumor was found, we personally performed surgery on the patient. We were responsible for the follow-up for half a year or even three years. Will the patient feel at ease?"

Guided by the direction of "five combinations", Professor Fu Chuangang also emphasized the management of subject quality. "I emphasize brand building very much. If one department and one expert do not have a brand, it is difficult for patients to trust you. To establish a brand, there must be good medical quality. So I have always had a spoken word to treat the treatment of each patient as one of our works, like a painter and a sculptor, and strive to make each work into a fine product. From diagnosis, grasping the indications of the surgical procedure to the implementation of the operation, post-operative follow-up, the entire treatment process must make the patients feel at ease and at ease."

It is not easy to maintain constant quality. Professor Fu Chuangang grouped the doctors in the department according to the professional direction. Every morning, he asked the doctors from each group to discuss the cases he had been admitted, and he personally checked. "I will do the surgery that requires me to take the stage and do our best to maintain the constant medical quality."

Attention to academics is also an important direction for Professor Fu Chuangang to shape the department brand. In addition to reading, writing books, and writing articles, Professor Fu Chuangang also actively participates in domestic and foreign academic exchanges. Every time he gives a speech, he will talk about new topics. "Because you have to prepare for new topics, you have to read many books and think about many issues. In different fields and different professional points, you have gradually accumulated and improved."

In addition to going out for academic exchanges, Professor Fu Chuangang also requires that the department often hold small academic seminars. Every year, he also holds international conferences and invites top domestic and foreign experts to attend the conference and exchanges. When he was in Changhai Hospital, the name of the academic conference was "Changhai Anorectal Surgery Week". After coming to Oriental Hospital, he changed the name of the conference to "Lujiazui International Anorectal Surgery Week".

Professor Fu Chuangang initiated the meeting, and he asked doctors from Cory to come on stage to give a report. "The protagonist of the speech is us, including doctors from other relevant departments in the hospital. The purpose of our meeting is to demonstrate and promote our own academic activities and promote the construction of our brand. Through this international conference, we can understand and absorb the most cutting-edge technologies and experiences in the world."

Guided by this department construction model and concept, Fu Chuangang spent 13 years to build the anorectal surgery department of Changhai Hospital into the first place in Shanghai. After coming to Oriental Hospital, it took him only five years to turn the gastroenterology and anorectal surgery department of Oriental Hospital from the innovator department, and now it has entered the first echelon of domestic anorectal surgery department.

When choosing a professional direction, although there are multiple professional directions such as vascular surgery, plastic surgery, liver, gallbladder and pancreas, Fu Chuangang chose an anorectal surgery department that is not strong even today.

Regarding this choice, Professor Fu Chuangang explained, "I hope to be a doctor who can truly solve common diseases and frequently occur. Hemorrhoids, anal fissures, anal fissures, constipation, colorectal cancer and other anorectal diseases. There are many patients, but the domestic medical level is not high. I hope to combine colorectal and anal diseases together to change this situation through hard work."

Regarding his transition from an anorectal surgeon to becoming a world-renowned expert in the field of surgery and being elected as an honorary academician of the American Academy of Surgery, Professor Fu Chuangang summarized it into four words: accumulate strength and make progress.

He graduated from the Second Military Medical University in 1984 until 1997. Professor Fu Chuangang was studying for the past 13 years. From 1987 to 1992, during this period, he finished his graduate studies and went to the Fourth Military Medical University in Xi'an to study English twice. In 1994, he took the national overseas examination, got the first place in the school, received a medical scholarship, and went to Changchun, Shenyang to study Japanese for 9 months. These all laid the foundation for him to study abroad in the future.

In 1995, after just six months of working in Denmark, Fu Chuan went to work at the University of Tokyo, Japan for two years. "When I arrived in Japan, I thought I must choose the best expert in anorectal surgery in Japan. Professor Cheichiro Muto was the president of the Japanese Surgery Association at that time and was very influential in the international community, so I chose to study with him."

Professor Cheichiro Muto is the first surgical expert in Asia to receive the title of "Honorary Committee" of the American Association of Colorectal Surgeons. In 2014, Professor Fu Chuangang also won the honorary title and is the third Asian surgical expert to receive this honor.

During this period, the experience of studying abroad became the key to Professor Fu Chuangang's ability to lead the department to success in the future. "Language advantages, professional and technical advantages and international networks support me to hold international conferences, and top experts from all over the world are also willing to attend. I remember that when I was thirty-three or four years old, no matter when I went to Denmark, Japan, and later to the United States to attend academic conferences, I was always proactive, actively interacting with others, slowly establishing relationships, always standing at the forefront of the world, learning and absorbing the latest concepts, latest technologies, vision and height are naturally different."

Focusing on "low-position anal protection" was the development direction set by Professor Fu Chuangang for the department back then. Nowadays, most of the intestinal cancer patients who look for Fu Chuangang are also trying to "protect anal protection".

Once upon a time, whether to save your life or protect your anus was a multiple-choice question for patients with low rectal cancer, but even if the patient loses his anus, he has no quality of life. In Professor Fu Chuangang's view, he must not only save his life for the patient, but also protect his anus, and also ensure that he has functions after protecting his anus.

Professor Fu Chuangang has pioneered the world's first rectal lag-out anastomosis (pista), which has helped most patients with benign lesions such as early ultra-low rectal cancer and familial polyposis, rectal diffuse adenomas, rectal diffuse hemangiomas, and rectal diffuse hemangiomas to retain their anus and return to normal life.

But even today, for low-level rectal cancer patients, Professor Fu Chuangang believes that there are still two more regrettable phenomena: those who should protect the anus are not protected, and those who should protect the anus are not protected. "This is a big problem, so we hold international conferences every year, including going out to give lectures and holding training classes, which are all to improve the conceptual awareness and technical level of doctors in this professional field in China. Those who should protect must be kept, and those who should not be protected must not be protected."

Professor Fu Chuangang emphasized that patients with two conditions should never protect the anus. One is that the tumor grows on the anal canal and has violated the sphincter. If the anal cavity is barely protected, the tumor will be difficult to remove and easily recur. If the tumor is cut clean, part of the anal sphincter will be removed. The patient will suffer from feces incontinence and the quality of life is worse than the lack of protecting the anus.

Another situation where anal protection should not be protected is the local late stage of the tumor. During treatment, chemotherapy is usually done first, to reduce the tumor, and then undergo surgical resection. "But in relatively advanced tumors, even if radiotherapy is performed, there will still be some patients who do not have full confidence that they will be completely clean. If the patient has relapsed in the future, the patient will have a high possibility of recurrence. Once the anal protection recurs in the future, surgery will be required. Moreover, when radiotherapy and subsequent strengthening treatment are performed, the newly established rectal damage will be very severe. If there is no anal protection before, we can reduce the possibility of local recurrence through some other treatment methods."

For patients with advanced rectal cancer, even if they can undergo radical resection through adjuvant chemotherapy and targeted therapy, only one-third of the patients can only partially achieve this goal, and one-third of the patients in the late stage are basically ineffective, spend a lot of money, suffer a lot of injuries, and the disease is still progressing, which is also something that makes Professor Fu Chuangang feel particularly regretful.

In Professor Fu Chuangang's ward, 85% of patients with rectal cancer can save their lives, anal and retention functions. Although it is already at the top level in the world, he hopes that with the advancement of technology in the future, the diagnosis can be more accurate, the surgery will be more minimally invasive, the cure rate will be higher, and the quality of life of patients will be better.

After five years of development, Professor Fu Chuangang believes that the Department of Anorectal Surgery of Oriental Hospital has become one of the first-line anorectal surgery departments in Shanghai, but his goal is to build the Department of Gastroenterology and Anorectal Surgery of Oriental Hospital into an internationally renowned, first-class domestic department that leads the development of anorectal surgery from concepts to technology.
Chapter completed!