International Journal of Colorectal Disease最新文献

{"title":"Mesenteric defect closure versus non-closure after complete mesocolic excision in minimally invasive right colectomy: a retrospective study.","authors":"Arcangelo Picciariello, Vito Leonardo Pinto, Salvatore Fedele, Fabrizio Aquilino, Vincenzo Papagni, Leonardo Vincenti","doi":"10.1007/s00384-026-05199-3","DOIUrl":"10.1007/s00384-026-05199-3","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of the mesenteric defect after minimally invasive right hemicolectomy remains controversial, particularly in the setting of complete mesocolic excision (CME), where a large mesenteric defect is created. This study was aimed at evaluating whether mesenteric defect closure after CME reduces postoperative complications and whether the closure itself introduces additional risks.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted using a prospectively maintained database of patients with stage II-III right colon cancer who underwent minimally invasive right hemicolectomy with CME between May 2022 and July 2025. Patients were divided into two groups according to whether the mesenteric defect was closed or left open. Demographic, operative, and postoperative outcomes were analyzed, including postoperative ileus (POI), internal herniation, small bowel obstruction, operative time, and length of hospital stay.</p><p><strong>Results: </strong>A total of 87 patients were included: 46 underwent mesenteric defect closure, and 41 did not. Baseline characteristics were comparable between groups. Postoperative gastrointestinal bleeding occurred in eight patients (9%), while two patients (2.3%) developed anastomotic leakage, one in each group. No symptomatic internal hernias or small bowel obstructions were observed. POI occurred in three patients (3.5%) with similar incidence between groups. Operative time, bowel recovery, harvested lymph nodes, and length of hospital stay did not differ significantly. No complications related to mesenteric defect closure were observed.</p><p><strong>Conclusions: </strong>Mesenteric defect closure after minimally invasive right hemicolectomy with CME appears safe but does not significantly reduce postoperative morbidity. Given the low incidence of internal herniation, routine closure may not be necessary.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total anorectal reconstruction with gracilis muscle flap-assisted coloplasty following abdominoperineal resection: a case report.","authors":"Nikolaos Gabriel, Yanis Berkane, Jonathan Cornacchini, Fabio Ferrario, Antonios Tsimpoukelis, Alexandra Krana, Franck-Marie Leclere, Sotirios Gabriel, Nicolas Bertheuil, Stratis Gabriel","doi":"10.1007/s00384-026-05185-9","DOIUrl":"10.1007/s00384-026-05185-9","url":null,"abstract":"<p><strong>Introduction: </strong>Total anorectal reconstruction (TAR) can be challenging for surgeons aiming to achieve both anatomic and functional anal reconstruction. Techniques involving coloplasties and graciloplasties have been described but have yet to become routine procedures. In this report, we present a rare case of TAR combining a coloplasty with an innervated gracilis muscle flap. This case aims to illustrate the surgical approach and emphasize the critical role of physiotherapy in postoperative functional recovery.</p><p><strong>Methods: </strong>We report the case of a young female patient who underwent abdominoperineal resection (APER) following a low rectal carcinoma, resulting in a permanent end colostomy. Five years later, with no evidence of local or distant recurrence, the patient sought to improve her quality of life. TAR was performed by mobilizing the colon into the perineum and creating a neosphincter through an innervated gracilis muscle flap loop around the colon. Postoperatively, the patient underwent 6 months of intensive pelvic floor rehabilitation, including manometry-guided biofeedback therapy. This case report was prepared in accordance with the CARE (CAse REport) guidelines.</p><p><strong>Results: </strong>Minor revision surgeries were needed to optimize the perineal colostomy scar, and three dilatation procedures were performed over 4 years to manage mild stenosis. The neo-anus remains functional at the 5-year postoperative visit, with fecal continence achieved within 2 months.</p><p><strong>Conclusion: </strong>TAR is documented in the literature, though still not used systematically for various reasons, including inadequate muscle contraction, fatigability, and lack of neuroplastic adaptations in the central nervous system. Through this report, we demonstrate that an adequate surgical technique, followed by intensive pelvic floor training and manometry-assisted biofeedback to promote neuroplasticity, can provide successful outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of powered circular stapling devices on anastomotic leakage rates in colorectal surgery.","authors":"Catherine Kollmann, Theresa Eckart, Beata Kusnezov, Lars Kollmann, Matthias Kelm, Christoph-Thomas Germer, Johan Friso Lock, Sven Flemming","doi":"10.1007/s00384-026-05195-7","DOIUrl":"10.1007/s00384-026-05195-7","url":null,"abstract":"<p><strong>Introduction: </strong>Anastomotic leakage (AL) remains a severe complication after colorectal surgery, increasing morbidity and mortality. Powered circular staplers may influence anastomotic healing through standardised compression and power distribution. This study aimed to compare clinical outcomes of powered versus manual circular staplers for transanal anastomoses.</p><p><strong>Method: </strong>This retrospective single-centre cohort study included consecutive patients undergoing colorectal resection with transanal circular anastomosis between January 2022 and June 2025. Primary endpoint was the incidence of AL according to stapler type. To ensure comparability between groups, propensity score matching was performed.</p><p><strong>Results: </strong>Among 333 patients, powered staplers were used in 69.1% and manual staplers in 30.9%. The overall AL rate was 15.0%. AL was significantly associated with higher BMI (28.1 vs. 26.6 kg/m²; p = .021), ASA ≥ 3 (64.0 vs. 46.0%; p = .019), diabetes mellitus (24.0 vs. 8.1%; p .001), open (34.0 vs. 19.1%) or converted surgeries (14.0 vs. 4.9%; p = .004) and greater intraoperative fluid administration (2548.1 vs. 2188.8 ml; p = .015). Most patients (72.1%) followed enhanced recovery concepts (FAST TRACK) with trend toward lower adherence in the AL cohort (n.s.).  After propensity score matching, AL occurred in 9.7% following powered circular stapling and 11.8% following manual circular stapling (n.s.).</p><p><strong>Conclusion: </strong>In this cohort, powered stapling devices were not associated with lower anastomotic leakage rates compared with manual staplers for transanal circular anastomosis in patients managed under modern minimally invasive and FAST TRACK concepts.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transanal irrigation in clinical practice: a scoping review.","authors":"Elsa Splidt Jacobsen, Hugin Reistrup, Birthe Thing Oggesen, Jacob Rosenberg","doi":"10.1007/s00384-026-05188-6","DOIUrl":"10.1007/s00384-026-05188-6","url":null,"abstract":"<p><strong>Purpose: </strong>Transanal irrigation is a treatment that promotes predictable bowel emptying and enhances daily management of incontinence and constipation for individuals with bowel disorders. We aimed to map the application of transanal irrigation in clinical practice.</p><p><strong>Methods: </strong>This scoping review followed the PRISMA-ScR guideline, and the protocol was a priori registered at Open Science Framework. A systematic literature search was performed in PubMed, Embase, CINAHL, and Cochrane CENTRAL. We included original studies on adults (≥ 18 years) treated with self-administered transanal irrigation in outpatient settings. The review investigated irrigation protocols, equipment, patient selection, outcome measures, and reported harms.</p><p><strong>Results: </strong>Ninety-two studies, including 4,821 adults (41% female), were included. Most studies were observational (51%), and 57% were published in the last decade. Transanal irrigation was most often used for neurogenic bowel dysfunction (36%) and post-surgical conditions (27%). Irrigation volumes ranged from 400 to 2400 ml. Time spent on irrigation typically ranged from 20 to 70 min. Irrigation was commonly performed daily or on alternate days. The Peristeen® system was the most frequently used device. Outcome measures were inconsistent, with 40 different tools used. Most harms reported were minor; however, very rare but serious complications, such as rectal perforation, were reported.</p><p><strong>Conclusion: </strong>Transanal irrigation was widely used in adult outpatient care, particularly for neurogenic and post-surgical bowel dysfunction, with recurring patterns in irrigation practices. However, heterogeneous outcome reporting limits comparability, highlighting the need for standardized measures and clearer clinical guidance.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleral image analysis via artificial intelligence to evaluate inflammatory status in inflammatory bowel disease.","authors":"Ying Li, Pinyi Huang, Lei Wang, Shuijiao Chen, Guanghui Lian, Fujun Li, Xiaowei Liu, Fanggen Lu, Yani Yin","doi":"10.1007/s00384-026-05190-y","DOIUrl":"10.1007/s00384-026-05190-y","url":null,"abstract":"<p><strong>Purpose: </strong>Among the extraintestinal ocular manifestations of patients with inflammatory bowel disease (IBD), episcleritis is associated with the inflammatory activity of IBD. The use of artificial intelligence to evaluate scleral images may help establish a non-invasive method for assessing the degree of inflammation. This study aims to provide a new approach for evaluating IBD inflammation by analyzing scleral images.</p><p><strong>Methods: </strong>We collected scleral images from patients with IBD across different inflammatory states and from controls. Then, we analyzed the images using the MASK R-CNN and HRNet method to build models for assessing the degree of inflammation.</p><p><strong>Results: </strong>A total of 942 scleral images were collected and divided into 5 groups: the control group, inflammatory Crohn's disease (ICD) group, CD in remission (RCD) group, inflammatory ulcerative colitis (IUC) group, and UC in remission (RUC) group. In the training set, the accuracy and F1-score for discriminating between IBD and non-IBD controls, inflammatory IBD and IBD in remission, ICD and RCD, IUC and RUC were 99.02%, 97.99%, and 98.44%, 98.34%, and 99.04%, 98.98%, and 100%, 100%, respectively. In the test set, the accuracy, F1-score and the Area Under the Curve (AUC) were 95.59%, 92.5%, 92.9%, and 85.1%, 81.2%, 85.8%, and 74.2%, 72.5%, 77.9%, and 92.9%, 91.1%, 91.3%, respectively. The inflammatory ulcerative colitis group exhibited the most prominent scleral congestion, which was correlated with disease severity.</p><p><strong>Conclusion: </strong>In this small-sample exploratory study, we propose that the evaluation of ocular manifestations in patients with IBD may serve as a non-invasive method for assessing inflammatory activity, especially in patients with UC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning prediction of increased healthcare utilization in colectomy for inflammatory bowel disease.","authors":"Gustavo Salgado-Garza, Elliot Ballato, Cynthia Araradian, Maura Walsh, Sandy H Fang, V Liana Tsikitis","doi":"10.1007/s00384-026-05184-w","DOIUrl":"10.1007/s00384-026-05184-w","url":null,"abstract":"<p><strong>Purpose: </strong>Healthcare spending for patients with inflammatory bowel disease (IBD) has steadily increased over the past few decades. While some of the increase is due to the rise in the use of biologics, surgery and postoperative care contribute significantly to healthcare spending. We aimed to analyze the preoperative factors associated with increased healthcare resource utilization (HRU) by developing and internally validating machine learning prediction models for increased HRU.</p><p><strong>Methods: </strong>We analyzed the ACS-NSQIP database from 2018 to 2022 to identify preoperative factors that could predict increased HRU in patients undergoing non-emergent colectomy for Crohn's disease or ulcerative colitis. Increased HRU was defined as a composite of either (a) discharge destination other than home, (b) readmission within 30 days of surgery, or (c) prolonged length of stay. A total of six machine learning algorithms were utilized to find the best-performing model determined by area under the curve. Models were internally validated with an 80:20 training and testing split.</p><p><strong>Results: </strong>A total of 7535 patients were analyzed. The overall rate of increased HRU was 33%. The best-performing model was the random forest, achieving an AUC of 0.75, an accuracy of 0.73, and an F1 of 0.82. The most important preoperative variables for model accuracy were albumin, hematocrit, and creatinine.</p><p><strong>Conclusion: </strong>Machine learning may assist in identifying IBD patients at risk for increased healthcare resource utilization. Here, we propose a predictive model in the preoperative setting that may allow targeted perioperative planning to optimize outcomes and resource use.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of socioeconomic deprivation on colorectal cancer outcomes; a retrospective regional cohort study.","authors":"Carolyn Cullinane, Roisin Coyne, Emma McNamara, Aaron O Mahony, Grzegorz Korpanty, Mazen El Bassiouni, Eoghan Condon, Colin Peirce, Patrick O'Donnell, Calvin Coffey, Christina Fleming","doi":"10.1007/s00384-026-05183-x","DOIUrl":"10.1007/s00384-026-05183-x","url":null,"abstract":"<p><strong>Background: </strong>Although colorectal cancer (CRC) survival and outcomes are improving worldwide, there is emerging recognition of the impact of social deprivation on disparities in CRC outcomes. The reasons for the disparities in incidence and mortality amongst different socioeconomic groups are complex and not fully understood. The aim of this study was to explore the impact of socioeconomic deprivation on CRC presentation, treatment course and outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with CRC at University Hospital Limerick was performed. A mixed-effects logistic regression analysis approach was utilised to determine the association between socioeconomic deprivation and various CRC outcomes. Data was analysed using IBM SPSS V29.0.2.0 (20).</p><p><strong>Results: </strong>Six hundred thirty-one patients were eligible for inclusion. Twenty were more likely to present with metastatic disease (OR 1.87, 95% CI 1.002-3.497, p = 0.049) or present as an emergency (OR 3.47, CI 2.283-5.274) than non-socioeconomically deprived groups. Of the 466 patients that were treated with curative intent, persons with a lower social deprivation score were more likely to require a stoma (OR 0.25, CI 0.152-0.439) and develop disease recurrence (OR 2.60, CI 1.491-4.467).</p><p><strong>Conclusion: </strong>Those living in more deprived areas face barriers to accessing timely healthcare and are more likely to present as an emergency or with metastatic CRC. These findings could help inform more effective targeting of public health interventions for CRC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curves in Versius-assisted colorectal surgery: a risk-adjusted CUSUM analysis from a single center.","authors":"Tomasz Sachańbiński, Maciej Miodoński, Jakub Kropieniewicz","doi":"10.1007/s00384-026-05189-5","DOIUrl":"10.1007/s00384-026-05189-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate procedure- and operator-specific learning curves in Versius-assisted colorectal cancer surgery using risk-adjusted cumulative sum (RA-CUSUM) analysis in a real-world single-center setting.</p><p><strong>Methods: </strong>This retrospective study included consecutive adult patients with histologically confirmed colorectal cancer who underwent elective robotic surgery using the Versius system between December 2022 and August 2025. Right hemicolectomy (RHC), sigmoid resection (SR), and anterior rectal resection (AR) were analyzed. Learning curves were assessed using RA-CUSUM analysis of skin-to-skin operative time, adjusted for patient- and procedure-specific variables. Separate models were constructed for each procedure and operator.</p><p><strong>Results: </strong>A total of 156 procedures were included: 79 AR, 51 RHC, and 26 SR. Median operative time was 215 min (IQR 185-255). Conversion to open surgery was low (3.2%), and major postoperative complications were infrequent. RA-CUSUM analysis demonstrated distinct procedure- and operator-specific learning patterns. RHC and SR reached earlier stabilization, whereas AR required a higher case volume to achieve consistent operative time reduction, with more prolonged variability in the learning phase. Oncological quality indicators were within accepted standards.</p><p><strong>Conclusion: </strong>Learning curves in Versius-assisted colorectal surgery are procedure- and operator-dependent. RA-CUSUM provides a structured method for monitoring trends in operative performance and may support structured training pathways and quality monitoring during implementation of robotic surgery programs.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term disease-free survival in young-onset rectal cancer patients surgically treated with curative intent: a retrospective cohort study.","authors":"Oddne Fjellstad Johnsen, Rolf Nerem Riis, Sebastian Meltzer, Anne Hansen Ree, Knut Magne Augestad","doi":"10.1007/s00384-026-05191-x","DOIUrl":"10.1007/s00384-026-05191-x","url":null,"abstract":"<p><strong>Purpose: </strong>Although colorectal cancer incidence is declining among individuals aged over 50 years, possibly due to screening, young-onset rectal cancer (YORC) in those under 50 years of age is increasing. YORC is often diagnosed at advanced stages, leading to worse outcomes and higher mortality. This study compared short- and long-term clinical, surgical, and pathological outcomes, including survival, between patients with YORC (< 50 years) and older age groups.</p><p><strong>Method: </strong>A retrospective single-center study of patients undergoing curative-intent resection for rectal cancer at a Norwegian university hospital from 2014 to 2024. We divided the cohort into three age groups: < 50 (YORC), 50-75, and > 75. Clinical and pathological parameters, surgical complications, and overall and disease-free survival (DFS) were compared using parametric and nonparametric analyses, Kaplan-Meier methods, and Cox proportional hazard regression.</p><p><strong>Results: </strong>642 patients underwent curative-intent surgery for rectal cancer: YORC: n = 53 (8%); 50-75: n = 435 (68%); and > 75: n = 154 (24%). The mean age for YORC was 44 years (range 26-49). The median follow-up was 52.4 months, with an interquartile range (IQR) of 27.9-85.6 months. The oldest age group had worse DFS during follow-up (p < 0.0001, log-rank test); YORC 7 events (13.5%); 50-75 67 events (16.1%); and > 75 66 (44.9%). DFS was comparable between the YORC and the 50-75 group (p = 0.6, log-rank test). Cox models showed poorer DFS in patients aged > 75 (hazard ratio 3.04, p = 0.009) and in those with higher American Society of Anesthesiologists scores or higher pathological stages.</p><p><strong>Conclusion: </strong>The YORC group had DFS outcomes comparable to those of patients aged 50-75 following curative-intent surgery. WHAT DOES THIS PAPER ADD TO THE LITERATURE?: While the incidence of YORC has increased over the past decades, few studies have analyzed survival beyond five years. This study compares YORC patients who were followed for a median of more than five years with groups of older patients with shorter follow-up (56.0 months for those aged 50-75 years, and 39.7 for those aged > 75). The outcomes for YORC patients, including disease-free survival, were comparable to those aged 50-75.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-center experience with robotic colorectal surgery for benign indications.","authors":"Sowmiya Gunabalasingam, Krupa George, Chamaldi de Silva, Selena Tsz Wai Chang, Fang Yi Cheung, Valentin Butnari, Phakanant Chaichanavichkij, Sandeep Kaul, Matthew Hanson, Richard Boulton, Joseph Huang, Nirooshun Rajendran","doi":"10.1007/s00384-026-05179-7","DOIUrl":"10.1007/s00384-026-05179-7","url":null,"abstract":"<p><strong>Purpose: </strong>Robotic colorectal surgery is established for malignant indications, but evidence supporting its use in benign disease remains limited. We describe perioperative outcomes of 403 consecutive robotic colorectal resections across all indications at a single UK NHS center, with primary focus on safety across benign indications.</p><p><strong>Methods: </strong>Retrospective analysis of a prospectively maintained database (February 2020-November 2025). Cases were stratified by indication: malignant or highly suspected malignancy (n = 332, 82.4%) and benign (n = 71, 17.6%). Benign cases were subclassified into diverticular disease (n = 39), ulcerative colitis (n = 14), Crohn's disease (n = 13), and other (n = 5). Primary outcomes were operative time, length of stay, and Clavien-Dindo complication grade.</p><p><strong>Results: </strong>Benign patients were younger (median 53 vs. 68 years; p < 0.001) with higher rates of prior abdominal surgery (33.8% vs 19.6%; p = 0.012). Across all 403 cases, median operative time was 240 min (IQR 199-302), median LOS 5 days (IQR 4-8), and CD Grade III-IV rate 9.2%. Despite equivalent operative times (p = 0.84), benign cases converted more frequently (15.5% vs 6.9%; p = 0.031), independently predicted by age (OR 1.04; p = 0.013), and cancer indication (OR 0.31; p = 0.012). Within the benign cohort, IBD patients were younger than those with diverticular disease (p < 0.001). Procedure type and stoma rates differed significantly by subgroup (both p < 0.001), yet complication rates, operative time, and LOS were equivalent.</p><p><strong>Conclusion: </strong>Robotic colorectal surgery is safe and reproducible across malignant and benign indications within specialised colorectal robotic centers. Complication profiles matched published benchmarks. Benign cases had a higher conversion rate, but this was driven by prior surgical burden and operative complexity, not platform limitation, and it did not increase morbidity. These data constitute the largest single-center UK evidence base for robotic colorectal surgery across all indications and support the expansion of robotic commissioning into benign practice.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}