According to the statistical information released by Shanghai Civil Affairs Bureau, Municipal Office for the Aging and Municipal Bureau of Statistics, by the end of 2014, Shanghai’s elderly aged 60 and above accounted for 28.8% of the total population (15.5% nationwide), of which 18.8% of the total population was aged 65 and above (10.1% nationwide), and Shanghai has entered a stage of deep aging. Meanwhile, according to the colorectal cancer screening for Shanghai community residents, the incidence of bowel cancer in the city has risen from the 6th to the 2nd place of common malignant tumors since the early 1970s, and the incidence rate in the urban area has increased from 12/100,000 to 59/100,000 at present, with an average annual growth rate of more than 4%. Due to the aging population structure, the overall trend of bowel cancer patients we encounter now is also advanced in age (the average age of bowel cancer patients in Shanghai is 73 years old). More than 80% of patients with bowel cancer in China are in the middle to late stage or progressive stage, and even 20% of them already have distant organ metastasis or local invasion when they are detected. Coupled with the degenerative changes in the systemic tissues and organs, reduced physiological reserve function, low compensatory capacity and immune function, and marginal function of important organs, elderly patients may have multiple diseases such as pulmonary diseases, cardiovascular diseases, diabetes mellitus and other coexisting diseases, which bring many risks to the perioperative management. Therefore, the treatment of high-age and high-risk bowel cancer will become our main battlefield at present and even in the last decade. The results of domestic and international clinical studies over the years have shown that the treatment of colon cancer has its own characteristics and rules, and it is not as simple as “operate immediately upon detection”. Compared with Europe, America, Japan and Korea, the 5-year survival rate of bowel cancer patients in China is lower after surgery, which is not only related to the late detection of the disease due to insufficient colonoscopy screening and more progressive cases, but also to the lack of standardized multidisciplinary treatment (MDT). This also leads to significant differences in the outcome of bowel cancer treatment in different regions of China. In view of the characteristics of older age, more comorbidities and late stage of bowel cancer patients in China, sequential MDT treatment should become should become the standard process. First, the evaluation of the disease and the development of treatment process and strategy for first-time bowel cancer patients need to be discussed by a multidisciplinary team composed mainly of surgical oncology, medical science, radiotherapy oncology and radiology. Second, for patients who enter the surgical process directly or after preoperative radiotherapy and/or targeted therapy (which can be neoadjuvant or translational therapy), perioperative safety control requires close cooperation of more multidisciplinary teams, including cardiology, pulmonary medicine, anesthesiology, ICU, etc. It is common for most elderly patients to have varying degrees of combined hypertension, coronary artery disease, diabetes, a history of cardiovascular accidents or even a cardiac stent. It is also crucial to conduct a scientific assessment of the impact of comorbidities on surgical risk and some preoperative education for patients and family members before surgery. Pre-operative cardiopulmonary and other vital organ function adjustments are also critical for rapid post-operative recovery. For example, a patient who has been smoking for many years needs to be instructed on how to cough and spit after surgery to help postoperative lung infections in addition to preoperative smoking ban and respiratory nebulization management. Preoperative scientific evaluation is also essential for the prevention of postoperative comorbidities, and patients with cardiovascular stents should be taken off oral warfarin for at least one week before surgery and treated with low molecular heparin. The need for appropriate postoperative hemostatic drugs is also necessary. Hemostasis and blood activation become a contradiction, and through preoperative evaluation we can transform the contradiction at the best postoperative entry point to avoid heart stent blockage. Thirdly, mainly for the current situation that China’s bowel cancer is mainly middle and late stage cases, and the characteristic of high recurrence rate of bowel cancer after surgery (more than half of patients will have recurrence and metastasis after surgery), for such locally advanced or metastatic at the time of discovery, recurrence after surgery and other bowel cancer cases, the surgery is difficult, technically demanding, risky and requires multiple surgical departments on the same stage, which is the concept of multidisciplinary surgical departments, for these For these complex cases, joint attack and hybridization of techniques from different departments are often the only way to achieve radical resection of the tumor and possibly long-term survival. In some patients with postoperative rectal cancer, the tumor recurred next to the anastomosis and invaded the sacrum, so we combined with orthopedic surgery to remove the tumor and part of the sacrum at the same time. There are also recurrence of bowel cancer invading the uterine cervix and pelvic wall, which is the so-called “frozen pelvis”, and the death sentence was pronounced in the past. However, we have successfully performed total pelvic resection in conjunction with gynecology and urology for some of these advanced bowel cancer patients, giving them a second chance to live. In addition, we believe that psychological counselors have a positive effect on the diagnosis and treatment of the disease. During the process of disease development and treatment, the psychological state of patients and their families is constantly changing. Resistance and support are constantly transformed and continue throughout. One person is sick and the family is worried, and even several families are worried. The psychological counselor can provide appropriate psychological counseling to patients and family members to relieve tension and build confidence in fighting tumor together. We always believe that the patient is the main force, and the doctor and family members work together to assist the patient in the attack, so that the three can work together to kill and injure the enemy to the maximum. Some psychological counseling for mind adjustment is more important in the treatment stage, “attitude determines everything”. We have invited psychological counselors who can give psychological counseling at the right time. For this reason, our hospital has set up the “Complex Bowel Cancer Multidisciplinary Diagnosis and Treatment Integration Clinic” to move the diagnosis and treatment of such complex colorectal cancer to the outpatient clinic, dedicated to the joint multidisciplinary diagnosis and treatment of complex bowel cancer, clarifying the treatment path, evaluating the possibility and risk of surgical resection, designing individualized surgical plans, discussing the perioperative safety control, implementing complex The clinic is dedicated to the joint multidisciplinary treatment of complex bowel cancer, clarifying the treatment path, assessing the possibility and risk of surgical resection, designing individualized surgical plans, discussing perioperative safety control, performing complex surgery, formulating postoperative rehabilitation plans, evaluating quality of life, establishing medical records and long-term follow-up. The clinic has a working secretary in addition to specialists from relevant departments, which is convenient for patients and allows them to receive opinions from multidisciplinary specialists in a single visit, avoiding the trouble of difficult outpatient appointments, multiple visits, and the hassle of multidisciplinary discussions followed by referrals after hospitalization. Patients can make appointments for this integrated clinic by phone at the appointment center, on the website of the Sixth Hospital, through the secretary’s email address, or through the specialists’ personal medical websites. Patients provide complete case information, imaging data, previous visits and surgical records as much as possible after making an appointment, which greatly improves the efficiency of the consultation. By involving experts from more departments, sharing resources and joining forces, we truly put patients at the center and integrate all advantageous technical forces to improve the surgical resection rate and safety of intestinal cancer patients, especially those of high age and high risk thus prolonging post-operative survival and improving life quality. This is our aim, to truly achieve “intestinal treatment for a long time”.