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Colorectal Surgery: Current Practice and Future Perspectives
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Colorectal Surgery: Current Practice and Future Perspectives

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

Deadline for manuscript submissions: closed (20 December 2025) | Viewed by 6014

Special Issue Editor

Prof. Dr. Karel Kostev

E-Mail
Guest Editor
1. Epidemiology, IQVIA, 60549 Frankfurt, Germany
2. University Hospital, Philipps University of Marburg, 35043 Marburg, Germany
Interests: antibiotic resistance; respiratory tract infections; urinary tract infections; phytopharmaceuticals; infections in children; real-world evidence; real-world data
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Colorectal surgery, which includes procedures involving the colon, rectum, and anus, is a critical field in the treatment of various gastrointestinal disorders, including colorectal cancer, diverticulitis, inflammatory bowel disease, and more. Advances in surgical techniques have significantly improved patient outcomes, reduced recovery times, and minimized complications. Among the key developments in this field are the contrasting approaches of minimally invasive surgery, including laparoscopic and robotic-assisted techniques.

Open surgery often results in longer hospital stays, increased pain, and a higher risk of infection. In contrast, minimally invasive surgery employs smaller incisions, specialized instruments, and sometimes robotic assistance to perform the same procedures with greater precision. These techniques have been associated with reduced postoperative pain, quicker recovery, and better cosmetic outcomes.

We hope to investigate all aspects of colorectal surgery. We await receiving original articles, reviews, systematic reviews, meta-analyses, and clinical research. With this Special Issue, we aim also to provide a 'view' of the current practice and future perspectives of colorectal surgery.

Prof. Dr. Karel Kostev
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colorectal surgery
  • minimal invasive surgery
  • open surgery
  • robot assisted surgery
  • colorectal cancer
  • stomach cancer
  • pancreatic cancer
  • diverticular disease

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Published Papers (3 papers)

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Research

14 pages, 256 KB  
Article
Evaluating the Role of Retrieval Bags in Mitigating Contamination During Minimally Invasive Colorectal Surgery
by Javier Valdes-Hernandez, Andrea Balla, Christof Mittermair, Christian Obrist, Juan Carlos Gómez-Rosado, Katharina Pimpl, Eberhard Brunner, Jan Schirnhofer, Helmut Weiss and Salvador Morales-Conde
J. Clin. Med. 2026, 15(2), 726; https://doi.org/10.3390/jcm15020726 - 15 Jan 2026
Viewed by 332
Abstract
Objective: To evaluate the extent of intraoperative bacterial and tumour cell spillage during minimally invasive colorectal surgery and to assess the protective value of systematic specimen retrieval using a tear-proof extraction bag. Methods: This multicentre, prospective observational study included patients undergoing conventional or [...] Read more.
Objective: To evaluate the extent of intraoperative bacterial and tumour cell spillage during minimally invasive colorectal surgery and to assess the protective value of systematic specimen retrieval using a tear-proof extraction bag. Methods: This multicentre, prospective observational study included patients undergoing conventional or single-port laparoscopic colorectal surgery for adenocarcinoma, premalignant polyps, or chronic diverticulitis. Three intraoperative samples were obtained for microbiological and cytological analysis: after pneumoperitoneum induction (sample 1), after vascular ligation and bowel division (sample 2), and after specimen extraction using a retrieval bag (sample 3). Results: Eighty-eight patients were included. Bacterial contamination increased significantly throughout the procedure occurring in 11.4% of sample 1, 37.5% of sample 2, and 67% of sample 3 (p < 0.001). When sample 1 was positive, sample 2 was positive in 100% of cases; when sample 2 was positive, sample 3 was positive in 79% of cases. In 33 patients (37.5%), bacterial growth was detected exclusively in sample 3. Contamination in sample 2 was significantly associated with surgical approach (p = 0.013), anastomotic technique (p = 0.022), and malignant disease (p = 0.038). A longer hospital stay was significantly associated with contamination in samples 1 and 2 (p = 0.014 and p < 0.001, respectively). No tumour cells were detected in any sample, except for one case showing atypical cells without clinical relevance in sample 3. Conclusions: Intraoperative bacterial contamination progressively increases during minimally invasive colorectal surgery, peaking after specimen extraction. Most clinical and surgical variables did not significantly influence contamination rates. The use of a specimen retrieval bag demonstrated a potential protective effect by containing bacterial spillage. However, no protective effect regarding tumour cell dissemination could be demonstrated based on cytology analysis. Full article
(This article belongs to the Special Issue Colorectal Surgery: Current Practice and Future Perspectives)
9 pages, 207 KB  
Article
Doppler-Guided Haemorrhoidal Artery Ligation and Rectoanal Repair (HAL-RAR): An Institutional Experience
by Rathin Gosavi, Raelene Tan, David Zula, Simon Xu, Shiki Fujino, James Lim, Thang Chien Nguyen, William Teoh and Vignesh Narasimhan
J. Clin. Med. 2025, 14(15), 5397; https://doi.org/10.3390/jcm14155397 - 31 Jul 2025
Cited by 2 | Viewed by 4083
Abstract
Background: Doppler-guided haemorrhoidal artery ligation with rectoanal repair (HAL-RAR) is a minimally invasive alternative to conventional haemorrhoidectomy. While associated with reduced postoperative pain and quicker recovery, data on its safety, recurrence rates, and applicability across haemorrhoid grades remain limited, particularly in Australian [...] Read more.
Background: Doppler-guided haemorrhoidal artery ligation with rectoanal repair (HAL-RAR) is a minimally invasive alternative to conventional haemorrhoidectomy. While associated with reduced postoperative pain and quicker recovery, data on its safety, recurrence rates, and applicability across haemorrhoid grades remain limited, particularly in Australian settings. Methods: A retrospective review was conducted on 128 consecutive patients who underwent elective HAL-RAR at a single institution between February 2022 and December 2024. Data on demographics, operative details, postoperative outcomes, and recurrence were collected. Outcomes were stratified by haemorrhoid grade. Multivariate logistic regression was used to identify predictors of recurrence, day-case completion, and conversion to excisional surgery. Results: The median age was 49 years, and 77.3% had Grade II or III haemorrhoids. HAL-RAR was completed as a day case in 76.6% of patients. Postoperative urinary retention occurred in 3.9%, return to theatre in 0.8%, and 30-day readmission in 7.0%. The symptomatic recurrence rate was 17.6%. Grade IV haemorrhoids were independently associated with increased recurrence (aOR 3.64, 95% CI 1.03–12.84), reduced likelihood of day-case management (aOR 0.14, 95% CI 0.03–0.93), and higher conversion to excisional haemorrhoidectomy (aOR 7.23, 95% CI 1.13–46.40). Conclusions: HAL-RAR is a safe, effective, and low-morbidity option for the management of Grade II and III haemorrhoids, suitable for day-case surgery. In selected Grade IV cases, it may offer benefit, although with higher recurrence and conversion risk. Careful patient selection is essential, and longer-term prospective studies are needed to assess durability. Full article
(This article belongs to the Special Issue Colorectal Surgery: Current Practice and Future Perspectives)
11 pages, 434 KB  
Article
Can 3D Imaging Improve Results in Colorectal Cancer Laparoscopic Surgery?
by Juan Cintas-Catena, Andrea Balla, Javier Valdes-Hernandez, Luis Cristóbal Capitán-Morales, Salvador Morales-Conde and Juan Carlos Gómez-Rosado
J. Clin. Med. 2025, 14(13), 4437; https://doi.org/10.3390/jcm14134437 - 23 Jun 2025
Viewed by 1113
Abstract
Objective: The aim of this prospective comparative study is to report our experience with 3D laparoscopy in terms of surgeon’s discomfort with 3D vision, and to compare clinical outcomes with 2D laparoscopy in oncological colorectal surgery. Methods: From 2016 to 2017, all consecutive [...] Read more.
Objective: The aim of this prospective comparative study is to report our experience with 3D laparoscopy in terms of surgeon’s discomfort with 3D vision, and to compare clinical outcomes with 2D laparoscopy in oncological colorectal surgery. Methods: From 2016 to 2017, all consecutive patients who underwent elective colorectal surgery for malignancy were enrolled. Based on surgery, patients were grouped as follows: group A, right hemicolectomy; group B, left hemicolectomy; group C, sigmoidectomy; and group D, anterior resection of the rectum. Results: In total, 171 patients were included, of which 61 were in group A (45 3D and 16 2D), 18 in group B (15 3D and 3 2D), 44 in group C (30 3D and 14 2D) and 48 in group D (36 3D and 12 2D). The surgeon’s discomfort did not occur due to the 3D vision. Complication rate and mean length of hospital stay (LOS) were lower in the 3D group in comparison to 2D, even if without statistically significant differences, in group B (6.6% versus 66.6% and LOS 6.1 ± 5.2 versus 23 ± 21 days), C (6.7% versus 21.4% and LOS 5.9 ± 2.5 versus 9 ± 8.4 days) and D (27.8% versus 50% and LOS 11.9 ± 16 versus 13 ± 11.8 days), respectively. Conclusions: Despite the lack of statistically significant differences between 2D and 3D laparoscopy, this study reports promising trends in favor of 3D laparoscopy, particularly for complex procedures such as anterior resection. Further randomized prospective studies with larger sample sizes and longer follow-up are necessary to conclusively determine the clinical impact of 3D laparoscopy in colorectal surgery. Full article
(This article belongs to the Special Issue Colorectal Surgery: Current Practice and Future Perspectives)
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