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Colorectal Surgery: Innovative Techniques and Enhanced Patient Outcomes

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 2411

Special Issue Editors


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Guest Editor
Colorectal Surgery Unit, Campus Bio-Medico University Hospital, Via Álvaro del Portillo, 200, 00128 Rome, Italy
Interests: colorectal surgery; minimally invasive techniques; artificial intelligence; perioperative patient management; translational research in coloproctology

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Guest Editor
Division of Colon and Rectal Surgery, Humanitas Research Hospital, Via Alessandro Manzoni, 56, 20089 Rozzano, Italy
Interests: colorectal surgery; minimally invasive techniques; artificial intelligence; perioperative patient management; translational research in coloproctology

Special Issue Information

Dear Colleagues,

Colorectal surgery has experienced rapid advancements in recent years, with newer technologies and techniques increasingly becoming part of surgical practice. However, there are still many areas in coloproctology that remain underexplored, and the drive to clarify these uncertainties continues to grow, alongside the integration of innovations into clinical practice. The aim of this Special Issue is to provide a platform for critically evaluating how recent technological developments have influenced colorectal surgery outcomes, perioperative patient management, postoperative recovery, and the overall patient experience during surgery. Manuscripts are invited that critically assess the role of minimally invasive approaches, the application of artificial intelligence and big data in decision-making, perioperative patient optimization, the use of translational research in coloproctology, or the comparison of outcomes between various innovative approaches to colorectal diseases. Priority will be given to high-quality original studies and well-designed and conducted systematic reviews or meta-analyses that offer a concise and comprehensive overview of the current state of the art on a specific topic.

Dr. Filippo Carannante
Dr. Leandro Siragusa
Guest Editors

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Keywords

  • colorectal surgery
  • minimally invasive techniques
  • artificial intelligence
  • perioperative patient management
  • translational research in coloproctology

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Published Papers (3 papers)

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Research

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6 pages, 174 KB  
Article
Adenoma Detection Rates: Does Endoscopic Volume or Provider Specialty Matter More?
by Jacob Applegarth, Alexander Menning, Michael Tolkacz, Diane Studzinski and Matthew Ziegler
J. Clin. Med. 2025, 14(20), 7201; https://doi.org/10.3390/jcm14207201 - 13 Oct 2025
Viewed by 131
Abstract
Background: Adenoma detection rate (ADR) is a well-established quality indicator for colonoscopy. Previous studies have demonstrated a superior ADR for gastroenterologists versus non-gastroenterologists. However, the number of annual colonoscopies performed by non-gastroenterologists in these studies has been variable and often far fewer [...] Read more.
Background: Adenoma detection rate (ADR) is a well-established quality indicator for colonoscopy. Previous studies have demonstrated a superior ADR for gastroenterologists versus non-gastroenterologists. However, the number of annual colonoscopies performed by non-gastroenterologists in these studies has been variable and often far fewer than the number performed by gastroenterologists. Our study aims to compare ADR in gastroenterologists and specifically colorectal surgeons of comparable colonoscopy volumes at a single institution. Methods: A retrospective chart review of all screening colonoscopies for average-risk patients was performed at a single tertiary care facility, including colonoscopies performed by both gastroenterologists and colorectal surgeons. Univariate analysis was performed using GraphPad Prism v9.3.0. Results: No significant difference in overall adenoma detection rates (ADR) was appreciated between gastroenterologists and colorectal surgeons at our institution (36.3% (SD 12.3%) vs. 30.8% (SD 6.7%), respectively, p = 0.224). Colorectal surgeons were more likely to have a longer withdrawal time (15.20 min vs. 11.17 min). Gastroenterologists were more likely to collect any specimen during colonoscopy (40.4% vs. 53.6%). However, there was no statistically significant difference in ADR when comparing the top five highest volume colorectal surgeons and the top five highest volume gastroenterologists, and both high-volume groups met recognized benchmarks for male, female, and overall ADR (30%, 20%, 25%). Conclusions: Colorectal surgeons removed a similar number of tubulovillous adenomas compared to gastroenterologists. Gastroenterologists tend to remove more polyps overall, including more hyperplastic polyps and sessile serrated adenomas. Despite this, no significant difference in ADR was identified between high-volume colorectal surgeons and gastroenterologists. Full article
8 pages, 987 KB  
Article
Improved Survival with Improved NAPRC Compliance: A Single-Institution Experience
by Harry Wasvary, Jacob A. Applegarth, Scarlett Hao, Tyler A. Kowalczyk, Gayaneh Nazarian and Claire Bova
J. Clin. Med. 2025, 14(19), 6872; https://doi.org/10.3390/jcm14196872 - 28 Sep 2025
Viewed by 285
Abstract
Background: The National Accreditation Program for Rectal Cancer (NAPRC) was developed in 2017. This study investigates three-year survival after diagnosis of rectal cancer as a function of compliance with NAPRC standards. Methods: A prospective database recorded compliance with 15 NAPRC standards for patients [...] Read more.
Background: The National Accreditation Program for Rectal Cancer (NAPRC) was developed in 2017. This study investigates three-year survival after diagnosis of rectal cancer as a function of compliance with NAPRC standards. Methods: A prospective database recorded compliance with 15 NAPRC standards for patients diagnosed August 2019 through August 2021. This database was retrospectively reviewed for compliance and three-year survival after diagnosis. Results: Three groups were identified (low, moderate, and high compliance) without significant difference in age (p = 0.662), sex (p = 0.919), race (p = 0.88), or disease stage (p = 0.166) between groups. Compared to the least compliant group, both moderate- and high-compliance groups had statistically significant lower hazard ratios (HR 0.22 and HR 0.12, respectively). Conclusions: Increased compliance led to a significant survival benefit. Rectal cancer patients who received care adherent to at least eight components of the NAPRC standards had a significant survival benefit three years after diagnosis compared to patients with less compliance. Full article
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Other

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17 pages, 2202 KB  
Systematic Review
C-Reactive Protein in Peritoneal Fluid for Predicting Anastomotic Leakage After Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis
by Tharith Vun, Zhanghao Wu, Chetra Chea, Weidong Liu, Ran Tao and Youming Deng
J. Clin. Med. 2025, 14(6), 2099; https://doi.org/10.3390/jcm14062099 - 19 Mar 2025
Viewed by 1578
Abstract
Background: Anastomotic leakage (AL) is a serious and potentially fatal complication that can occur after colorectal cancer (CRC) surgery, and it significantly affects patient recovery and increases morbidity. While serum C-reactive protein (CRP) is a recognized systemic inflammatory marker, the level of [...] Read more.
Background: Anastomotic leakage (AL) is a serious and potentially fatal complication that can occur after colorectal cancer (CRC) surgery, and it significantly affects patient recovery and increases morbidity. While serum C-reactive protein (CRP) is a recognized systemic inflammatory marker, the level of CRP in peritoneal fluid may serve as a more specific and localized biomarker for early AL detection. This meta-analysis explores the diagnostic potential of peritoneal fluid CRP, aiming to enhance postoperative care for CRC patients. Methods: A comprehensive literature search was conducted following the PRISMA guidelines. Eligible studies were included based on strict inclusion and exclusion criteria. Diagnostic accuracy was pooled using a random-effects model. The risk of bias was assessed using the QUADAS-2 tool. Results: The pooled sensitivity and specificity were 0.74 and 0.83, respectively, with an area under the curve (AUC) of 0.84, indicating good diagnostic accuracy. The overall diagnostic performance was consistent for sensitivity with no significant heterogeneity, but high heterogeneity was observed for specificity, suggesting variability between studies. Subgroup analysis revealed improved diagnostic performance between postoperative days 5–7 and higher CRP cut-off values (70–150 mg/L). The analysis confirmed the stability of the results through a sensitivity analysis and found no significant publication bias. Conclusions: Peritoneal fluid CRP is a reliable biomarker for detecting AL after CRC surgery, especially in the later postoperative period. However, heterogeneity in study methodologies and patient populations limits the generalizability of the findings. Future research should focus on standardizing protocols and exploring additional biomarkers to improve diagnostic accuracy. Full article
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