International Journal of Colorectal Disease最新文献

{"title":"Role and mechanism of gut microbiota-host interactions in the pathogenesis of Crohn's disease.","authors":"Yao Xu, Runxiang Xie, Yuqing Weng, Yewei Fang, Shuan Tao, He Zhang, Huimin Chen, Axiang Han, Qi Jiang, Wei Liang","doi":"10.1007/s00384-025-04917-7","DOIUrl":"10.1007/s00384-025-04917-7","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is a chronic, nonspecific inflammatory bowel disease with a poor prognosis. Despite its increasing incidence, curing CD remains challenging due to its complex etiology and unclear pathogenesis.</p><p><strong>Methods: </strong>A comprehensive PubMed and Web of Science search was conducted using the keywords Crohn's disease, gut microbiota, dysbiosis, pathogenesis and treatment, focusing on studies published between 2014 and 2024.</p><p><strong>Results: </strong>Recent studies have demonstrated a close relationship between gut microbiota dysbiosis and the development of CD. Although many dysbioses associated with CD have not yet been proven to be causal or consequential, it has been observed that the gut microbiota in CD patients exhibits reduced diversity, a decrease in beneficial bacteria, and an increase in pathogenic bacteria. These changes may lead to decreased intestinal barrier function, abnormal immune responses, and enhanced inflammatory reactions, which are related to the disease's activity, phenotype, drug treatment efficacy, and postoperative therapeutic outcomes. Therefore, further exploration of the microbiota-host interactions and the pathogenesis of CD, the identification of biomarkers, and the development of targeted strategies for modulating the gut microbiota could offer new avenues for the prevention and treatment of CD.</p><p><strong>Conclusions: </strong>This review highlights the pivotal role of gut microbiota dysbiosis in driving CD pathogenesis and its progression, while underscoring its potential as a therapeutic target through dietary modulation, microbial interventions, and integrative strategies to improve clinical management and prognostic outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"130"},"PeriodicalIF":2.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173681","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":"Dual-energy CT combined with histogram parameters in the assessment of perineural invasion in colorectal cancer.","authors":"Yuxuan Wang, Huaqing Tan, Shenglin Li, Changyou Long, Boqi Zhou, Zhijie Wang, Yuntai Cao","doi":"10.1007/s00384-025-04919-5","DOIUrl":"10.1007/s00384-025-04919-5","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to evaluate the predictive value of dual-energy CT (DECT) combined with histogram parameters and a clinical prediction model for perineural invasion (PNI) in colorectal cancer (CRC).</p><p><strong>Methods: </strong>We retrospectively analyzed clinical and imaging data from 173 CRC patients who underwent preoperative DECT-enhanced scanning at two centers. Data from Qinghai University Affiliated Hospital (n = 120) were randomly divided into training and validation sets, while data from Lanzhou University Second Hospital (n = 53) served as the external validation set. Regions of interest (ROIs) were delineated to extract spectral and histogram parameters, and multivariate logistic regression identified optimal predictors. Six machine learning models-support vector machine (SVM), decision tree (DT), random forest (RF), logistic regression (LR), k-nearest neighbors (KNN), and extreme gradient boosting (XGBoost)-were constructed. Model performance and clinical utility were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Four independent predictive factors were identified through multivariate analysis: entropy, CT40_KeV, CEA, and skewness. Among the six classifier models, RF model demonstrated the best performance in the training set (AUC = 0.918, 95% CI: 0.862-0.969). In the validation set, RF outperformed other models (AUC = 0.885, 95% CI: 0.772-0.972). Notably, in the external validation set, the XGBoost model achieved the highest performance (AUC = 0.823, 95% CI: 0.672-0.945).</p><p><strong>Conclusion: </strong>Dual-energy CT-based combined with histogram parameters and clinical prediction modeling can be effectively used for preoperative noninvasive assessment of perineural invasion in colorectal cancer.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"129"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150389","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":"Development of an evaluation framework for robotic total mesorectal excision videos: a review and comparison of medical professional and public video resources.","authors":"Zohaib Arain, Michael G Fadel, Aksaan Arif, Henry Douglas Robb, Bibek Das, Liam Poynter, Christos Kontovounisios, Hutan Ashrafian, Daniel Lawes, Matyas Fehervari","doi":"10.1007/s00384-025-04914-w","DOIUrl":"10.1007/s00384-025-04914-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the quality of educational surgical videos for robotic total mesorectal excision (TME), across widely used open-source platforms, using a newly designed quality assessment checklist.</p><p><strong>Methods: </strong>The checklist was developed by using existing society guidelines, such as the European Academy of Robotic Colorectal Surgery, comprising four key sections: (i) usability of the platform, (ii) video component, (iii) intraoperative techniques and (iv) other information (including case presentation and outcomes). Videos were identified using the search terms 'Robotic TME' from surgical education platforms (WebSurg, C-SATS and Touch Surgery) and YouTube, between January 2016 and July 2024. All videos displaying robotic TME were reviewed and scored using the quality assessment tool (/12), and the videos across the platforms were subsequently compared.</p><p><strong>Results: </strong>A total of 113 videos were scored using the checklist: 63 surgical education platform (10 WebSurg and 53 C-SATS) and 50 YouTube videos. The total median checklist score achieved by WebSurg (9 [IQR 8-9] and YouTube videos (8 [IQR 7-10]) was significantly higher than CSAT-S videos (4 [IQR 4-5]; p < 0.001). The usability of platform scores for YouTube was significantly higher than WebSurg and C-SATS videos (p < 0.001). Scores for video components, intraoperative techniques and other information were higher across WebSurg and YouTube videos when compared to C-SATS (p < 0.001); however, there was no significant difference between WebSurg and YouTube for each domain.</p><p><strong>Conclusion: </strong>The overall educational quality of online robotic TME videos was found to be generally heterogeneous, with WebSurg and YouTube videos demonstrating higher scores based on the checklist. A new quality assessment tool has been proposed for robotic TME videos, which has the potential to improve the reliability and value of published video research.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"127"},"PeriodicalIF":2.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135994","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":"Critical appraisal of transperineal Doppler ultrasound as a diagnostic tool for hemorrhoidal recurrence.","authors":"Michele Schiano di Visconte","doi":"10.1007/s00384-025-04918-6","DOIUrl":"10.1007/s00384-025-04918-6","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"128"},"PeriodicalIF":2.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135988","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 surgical case load on recurrence rates in pilonidal sinus disease: a cross-study data synthesis.","authors":"Dietrich Doll, Matthias Maak, Ida Kaad Faurschou, Theo Hackmann, Christina Oetzmann von Sochaczewski, Myriam Braun-Münker, Igors Iesalnieks, Susanne Haas","doi":"10.1007/s00384-025-04883-0","DOIUrl":"https://doi.org/10.1007/s00384-025-04883-0","url":null,"abstract":"<p><strong>Purpose: </strong>A higher surgical caseload has been associated with better outcomes in various diseases. However, this relationship has not yet been studied for Pilonidal Sinus Disease (PSD). This study aimed to examine the impact of annual PSD surgery volumes on recurrence rates (RR).</p><p><strong>Methods: </strong>A comparative cross-study data synthesis was conducted, including 1074 studies with 130,599 patients, focusing on PSD recurrence rates. Studies were categorized based on annual case load (ACL) into three groups: fewer than 10 operations per year (group 1), 10-30 operations per year (group 2), and 30 or more operations per year (group 3). Kaplan-Meier analyses were performed to evaluate recurrence rates, with additional stratification by study design (randomized controlled trial (RCT) or non-RCT) and surgical treatment type.</p><p><strong>Results: </strong>In randomized controlled trials (RCTs) of primary open treatment, group 1 (< 10 surgeries/year) had a 5-year recurrence rate of 23.5%, while group 2 (10-30 surgeries/year) had a rate of 12.5% (p < 0.0001). No data was available for group 3. For primary midline closure (pmc), the 5-year recurrence rates were 14.8% for group 1, 26.3% for group 2, and 12.8% for group 3. Non-RCT studies generally showed decreasing recurrence rates with higher surgical caseloads for most treatment types. However, midline closure surgery showed no significant improvement in recurrence rates with increased caseloads.</p><p><strong>Conclusion: </strong>The study demonstrates that higher surgical caseloads significantly reduce PSD recurrence rates, with notable benefits observed for centers treating 30 or more patients annually. Specialization in high-volume centers may lead to improved outcomes for PSD, particularly in flap surgeries. However, midline closure surgery continues to show persistently high recurrence rates, regardless of caseload.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"126"},"PeriodicalIF":2.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208505","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":"Diagnostic value of genetic and epigenetic biomarker panels for colorectal cancer detection: a systematic review.","authors":"Georgios Alampritis, Sarah Nohelia Thoukididou, Maria Ramos, Pantelis Georgiou, Melpomeni Kalofonou, Constantinos Simillis","doi":"10.1007/s00384-025-04904-y","DOIUrl":"10.1007/s00384-025-04904-y","url":null,"abstract":"<p><strong>Purpose: </strong>Exploration of effective screening methods is imperative to improve current screening for colorectal cancer (CRC). Our aim was to systematically search the literature to identify and assess the diagnostic accuracy of both genetic and epigenetic biomarker panels for CRC detection using liquid biopsies for circulating tumour DNA (ctDNA) from stool, blood, or urine.</p><p><strong>Methods: </strong>A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) with searches in Medline, Embase, CENTRAL, and Web Of Science from inception up to March 20, 2025, using pre-defined keywords. Study quality assessment was performed using QUADAS-2 tool (Quality Assessment for Diagnostic Accuracy Studies 2). Primary and secondary outcomes were panel performance (sensitivity and specificity) for CRC, advanced precancerous lesions (APL), and staging of disease.</p><p><strong>Results: </strong>Forty-four studies were included. Exceptional performance for both CRC (sensitivity and specificity) and APL (sensitivity) was displayed by biomarker panels including methylated SDC2 with methylated SFRP1/2 (CRC: 91.5%/97.3%, APL: 89.2%) or methylated TFPI2 (CRC: 94.9%/98.1%, APL: 100%), and a 5-biomarker panel of mutational targets APC, Bat-26, KRAS, L-DNA, and p53 (CRC: 91.0%/93.0%, APL: 82.0%). Suboptimal APL sensitivities up to 57.0% were exhibited by Cologuard and variant panels (including KRAS, methylated BMP3, methylated NDRG4, FIT), and 47.8% for combinations including methylated SEPT9.</p><p><strong>Conclusions: </strong>High-performance, candidate ctDNA biomarker panels with exceptional diagnostic accuracy for both CRC and APL have been identified. Further work should focus on the development of large-scale studies to justify their clinical implementation.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"125"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119666","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":"Utility of C-reactive protein on the fourth postoperative day to detect complications beyond anastomotic dehiscence.","authors":"David Ortiz-López, Joaquín Marchena-Gómez, Yurena Sosa-Quesada, Manuel Artiles-Armas, Eva María Nogués-Ramia, Beatriz Arencibia-Pérez, Julia María Gil-García, Cristina Roque-Castellano","doi":"10.1007/s00384-025-04912-y","DOIUrl":"10.1007/s00384-025-04912-y","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative complications can affect recovery after colorectal cancer surgery. Elevated C-reactive protein (CRP) levels have been studied as a predictor of anastomotic dehiscence, but evidence regarding its association with overall complications is limited. This study aimed to explore the link between CRP levels on the fourth postoperative day and overall postoperative complications using the comprehensive complication index (CCI).</p><p><strong>Methods: </strong>The observational study included 935 patients who underwent colorectal cancer surgery between 2015 and 2022. Patients were categorized into three groups: no complications, complications excluding dehiscence, and complications with dehiscence. The relationship between CRP levels and postoperative complications was analyzed, and the optimal CRP cutoff point was determined.</p><p><strong>Results: </strong>The median CRP values were 34.3 (20.4-54.0) mg/L in the group with no complications, 69.9 (43.2-112.9) mg/L in the group with complications excluding dehiscence, and 167.6 (69.7-239.5) mg/L in patients with dehiscence. A significant correlation between CRP levels and postoperative complications was found (p < 0.001). Based on the identified cutoff points, CRP levels above 58 mg/L suggest the presence of any complication, including dehiscence. Levels between 42 and 58 mg/L suggest complications excluding dehiscence, and levels below 42 mg/L strongly exclude complications, with a negative predictive value of 82%.</p><p><strong>Conclusions: </strong>Elevated CRP on postoperative day 4 is associated with overall postoperative complications, not just dehiscence. A positive correlation exists between CCI score and CRP levels. A CRP value < 42 mg/L on day 4 allows clinicians to reliably exclude the presence of any complication.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"124"},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110502","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":"Predictors of difficulty in robotic splenic flexure mobilization during rectal cancer surgery.","authors":"Yusuke Yamaoka, Akio Shiomi, Hiroyasu Kagawa, Hitoshi Hino, Shoichi Manabe, Yusuke Tanaka, Shunsuke Kasai, Tetsushi Ishiguro, Akifumi Notsu","doi":"10.1007/s00384-025-04916-8","DOIUrl":"10.1007/s00384-025-04916-8","url":null,"abstract":"<p><strong>Purpose: </strong>In surgery for rectal cancer, splenic flexure mobilization is sometimes necessary to ensure a tension-free colorectal anastomosis with adequate blood supply. Splenic flexure mobilization is regarded as a challenging and risky maneuver, but there are no clear indicators of its difficulty in rectal cancer surgery. This study evaluated the impact of clinical and anatomical factors, including splenic flexure height measured qualitatively on the basis of vertebral level using computed tomography, on the difficulty of splenic flexure mobilization during rectal cancer surgery.</p><p><strong>Methods: </strong>The enrolled patients underwent robotic splenic flexure mobilization during rectal surgery for primary rectal cancer at Shizuoka Cancer Center in Japan between December 2011 and March 2022. All patients were scheduled to undergo splenic flexure mobilization preoperatively, and all procedures were carried out following a standardized approach. Linear regression analysis was conducted to determine the clinical and anatomical factors significantly influencing the operative time of the abdominal phase, which is defined as the duration from lymph node dissection around the inferior mesenteric artery to the mobilization of the sigmoid and descending colon, including the splenic flexure.</p><p><strong>Results: </strong>The median operative time for the abdominal phase was 88 min (range, 39-179 min). Univariate analysis revealed that the following variables were significantly correlated with a prolonged abdominal phase: higher body mass index, larger visceral fat area, and higher splenic flexure. In a multiple linear regression analysis, only higher splenic flexure remained significantly associated with a longer abdominal phase (p < 0.01).</p><p><strong>Conclusions: </strong>Splenic flexure height measured on the basis of vertebral level using computed tomography may be useful for predicting the difficulty of robotic splenic flexure mobilization in surgery for rectal cancer.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"122"},"PeriodicalIF":2.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086202","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":"Reoperation and mortality following elective surgery for chronic and recurrent colonic diverticular disease: A nationwide population-based cohort study.","authors":"Helene R Dalby, Rune Erichsen, Kaare A Gotschalck, Katrine J Emmertsen","doi":"10.1007/s00384-025-04915-9","DOIUrl":"10.1007/s00384-025-04915-9","url":null,"abstract":"<p><strong>Purpose: </strong>The ideal treatment for chronic and recurrent colonic diverticular disease (crDD) remains unresolved, partly due to lacking evidence regarding surgical safety. This study evaluated 90-day reoperation and mortality rates following elective surgery for crDD and explored predictors for reoperation and mortality.</p><p><strong>Methods: </strong>This national cohort study included all patients with crDD undergoing elective colonic resection or stoma formation in Denmark from 1996-2021. Outcomes were the 90-day cumulative incidence proportion (CIP) of reoperation and mortality, and predictors were explored in Cox proportional hazard models.</p><p><strong>Results: </strong>Among 35,174 patients with crDD, 3,584 (10%) underwent elective surgery. The 90-day reoperation rate was 18.0%; mortality was 1.6%. During the 25-year period, the reoperation rate declined 30%, from 19.5% to 13.8%, and mortality declined 74%, from 2.7% to 0.7%. Among 2,942 patients with colonic resection and no stoma formation, the reoperation rate due to anastomotic leak was 3.0% overall and 0.9% in the most recent years. Mortality was 18 times higher in patients aged ≥ 80 years versus those aged < 60 years (CIP 8.0% versus 0.4%). The reoperation rate was increased in patients with ≥ 4 hospital contacts or ≥ 3 admissions compared to patients with fewer contacts, while mortality was not associated with the number of hospital contacts before surgery.</p><p><strong>Conclusion: </strong>Elective surgery in crDD was safe with careful patient selection. The risk of reoperation due to anastomotic leak was very low. Patients with most hospital contacts had an increased reoperation rate, supporting consideration for elective surgery early in patients with disabling diverticular disease.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"123"},"PeriodicalIF":2.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093582","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":"Short- and long-term outcomes of robotic versus conventional laparoscopic surgery for middle or lower rectal cancer: a propensity score-matched analysis.","authors":"Toshinori Sueda, Masayoshi Yasui, Junichi Nishimura, Yoshinori Kagawa, Masatoshi Kitakaze, Ryota Mori, Yoshitomo Yanagimoto, Takashi Kanemura, Kazuyoshi Yamamoto, Hiroshi Wada, Kunihito Gotoh, Hiroshi Miyata, Masayuki Ohue","doi":"10.1007/s00384-025-04888-9","DOIUrl":"10.1007/s00384-025-04888-9","url":null,"abstract":"<p><strong>Purpose: </strong>The potential benefits of robotic surgery (RS) for rectal cancer (RC) remain uncertain. The objective of this study was to evaluate the short- and long-term outcomes of RS compared to conventional laparoscopic surgery (LS) for stage I-III middle or lower RC.</p><p><strong>Methods: </strong>This study retrospectively analyzed 350 consecutive patients with stage I-III middle or lower RC who underwent curative surgery from 2017 to 2021, employing propensity score matching (PSM) analysis.</p><p><strong>Results: </strong>Of 350 patients, 128 patients underwent RS. After PSM, we enrolled 256 patients. Median follow-up was 59.8 months. Before PSM, significant differences were observed between groups regarding primary tumor site (p = 0.02). After PSM, no significant differences between groups were observed in terms of operative time, blood loss, conversion rate, intra-operative and postoperative complications, or number of lymph nodes harvested. After PSM, 3- and 5-year cumulative LR rates were 3.2% and 3.2% in the RS group, and 2.8% and 3.2% in the LS group, respectively. The cumulative distant recurrence (DR) rates in the RS group were 13.4% at 3-year and 15.1% at 5-year, whereas in the LS group, they were 14.9% and 18.7%, respectively. No notable differences in cumulative LR or DR rates were evident between groups. Furthermore, no notable differences were observed between groups regarding overall, cancer-specific, or recurrence-free survival according to stage.</p><p><strong>Conclusions: </strong>RS appears to be viable and safe treatment approach for patients with middle or lower RC, offering short- and long-term outcomes comparable to those of LS.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"121"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086203","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}