For selected patients with stage II or III rectal cancer, a direct-to-surgery approach led to favorable 2-year oncologic outcomes.

• Local recurrence rate was just 1% among patients undergoing low anterior resection.
• Disease-free survival was 85%, and overall survival reached 99%.

Surprisingly, only 8% of patients required post-operative radiation therapy.

• Preoperative MRI overstaged 51% of patients who were ultimately confirmed as stage I.

End-to-side ileocolonic anastomosis is a low-risk option that can improve outcomes for Crohn’s disease patients after ileocecectomy.

• The end-to-side configuration showed lower blood loss and shorter operative times compared to other methods.
• Multivariable analysis revealed that elective surgery and end-to-side anastomosis correlated with a lower recurrence rate over a 32-month follow-up.

This technique is safe and easy to perform, making it a strong choice for surgical reconstruction in Crohn’s disease management.

Higher BMI significantly raises the risk of converting from minimally invasive to open surgery for colorectal procedures.

• Laparoscopic surgery rates were 36.4% in Nova Scotia versus 49.3% in the national cohort, with conversion rates of 23.1% and 19.3%, respectively.
• BMI was a strong predictor of conversion: odds ratio of 2.54 for Nova Scotia and 1.61 for the national cohort.

Surgeon experience matters—higher laparoscopic volume correlates with lower conversion rates, especially for right hemicolectomies. This underscores the need for careful patient selection and potential collaboration with experienced laparoscopic surgeons.

Minimally invasive surgery (MIS) shows promise for pT4 colon cancer without compromising long-term oncologic outcomes.

• In a study of 1,850 patients, those undergoing MIS had 2.4 times fewer major complications compared to open surgery.
• After 42 months of follow-up, overall recurrence rates were similar for both groups, with better disease-free survival (DFS) and overall survival (OS) for the MIS group.

Well-selected patients—such as those with favorable clinical characteristics—can benefit from MIS, enhancing recovery with reduced complications.

Robotic rectal resection shows a higher rate of primary postoperative ileus (POI) compared to laparoscopic surgery.

• Primary POI occurred in 25.4% of robotic patients versus 8.5% in laparoscopic patients (p=0.007).
• Intraoperative fluid balance was significantly higher in robotic surgery (36.0 vs. 29.2 ml/kg, p=0.0025) along with longer anesthesia time (403 vs. 346 min, p<0.001).

Focus on fluid management and reducing anesthesia time to lower the risk of POI in robotic procedures.

• Risk factors for primary POI include advanced age, male sex, and higher intraoperative fluid balance.