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Colon and Rectal Surgery: Recent Advances and Future Trends

A Special Issue of Journal of Clinical Medicine (ISSN 2077-0383) belonging to the section "General Surgery".

Deadline for manuscript submissions: 26 November 2026 | Viewed by 695

Editors


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Guest Editor
First Department of Surgery, General Hospital Papageorgiou, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
Interests: general surgery; laparoscopic cholecystectomy; hernia surgery; colorectal cancer; pancreatic cancer

Special Issue Information

Dear Colleagues,

Colorectal surgery represents one of the most rapidly evolving fields within modern surgical science. Since the establishment of the oncological principle of total mesorectal excision, significant advances in surgical technique—particularly the widespread adoption of minimally invasive and robotic approaches—have profoundly transformed the specialty, leading to measurable improvements in perioperative management and oncological outcomes.

In contemporary clinical practice, colorectal surgeons are increasingly required to integrate evidence-based medicine with individualized patient-centred decision-making, while accounting for the technical capabilities and infrastructure of their institutions. Surgical approach selection, perioperative risk stratification, complication prevention and management, multidisciplinary treatment coordination, and long-term functional outcomes have become essential components of comprehensive therapeutic planning.

Concurrently, the future trajectory of colorectal surgery is characterized by both opportunity and complexity. Continued innovation in robotic platforms, the incorporation of artificial intelligence and data-driven decision support systems, advances in preoperative imaging and staging, and the development of function-preserving and oncologically tailored surgical strategies—including organ preservation approaches—are redefining the scope and objectives of surgical intervention. These developments necessitate ongoing adaptation in surgical training, clinical practice, and multidisciplinary collaboration.

We warmly invite you to contribute to this Special Issue.

Dr. Paraskevi Chatzikomnitsa
Dr. Alexandros E. Giakoustidis
Guest Editors

Manuscript Submission Information

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Keywords

  • colorectal surgery
  • minimally invasive surgery
  • robotic surgery
  • artificial intelligence in surgery
  • surgical innovation

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Published Papers (1 paper)

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Review

23 pages, 949 KB  
Review
Artificial Intelligence-Assisted Colonoscopy for Colorectal Lesion Detection: Current Evidence, Challenges, and Future Directions
by Andreas Antzoulas, Francesk Mulita, Vasileios Leivaditis, Elias Liolis, Platon Dimopoulos, Vasiliki Tzelepi, Ioannis Maroulis and Christos-Nikolaos Anagnostopoulos
J. Clin. Med. 2026, 15(17), 6558; https://doi.org/10.3390/jcm15176558 - 25 Aug 2026
Viewed by 355
Abstract
Background: Colonoscopy is the gold-standard screening modality for colorectal cancer (CRC) prevention, enabling detection and endoscopic resection of premalignant polyps and reducing CRC incidence and mortality by up to 77% and 53%, respectively. However, colonoscopy effectiveness is substantially dependent on endoscopist expertise, with [...] Read more.
Background: Colonoscopy is the gold-standard screening modality for colorectal cancer (CRC) prevention, enabling detection and endoscopic resection of premalignant polyps and reducing CRC incidence and mortality by up to 77% and 53%, respectively. However, colonoscopy effectiveness is substantially dependent on endoscopist expertise, with significant inter-operator variability in adenoma detection rates (ADR) and, consequently, a risk of missed lesions, particularly diminutive and morphologically subtle adenomas. Recent advances in artificial intelligence (AI), specifically computer-aided detection (CADe) and computer-aided diagnosis (CADx) systems utilizing deep learning convolutional neural networks, have emerged as promising technologies to standardize lesion detection accuracy and reduce adenoma miss rates. Methods: A focused narrative literature review was conducted examining randomized controlled trials, meta-analyses, and implementation studies evaluating AI-assisted colonoscopy systems across diverse clinical populations and healthcare settings. Results: Evidence demonstrates that CADe systems consistently improve ADR, particularly for diminutive polyps and morphologically challenging lesions, though superiority over expert endoscopists remains inconsistent. CADx systems reliably meet ASGE-PIVI performance thresholds for diminutive polyp characterization, supporting implementation of resect-and-discard and diagnose-and-leave strategies. However, substantial heterogeneity exists regarding real-world effectiveness, cost-effectiveness, and optimal implementation frameworks across diverse settings. Conclusions: While AI-assisted colonoscopy demonstrates clinical promise in improving lesion detection and enabling optical diagnosis, realizing durable population-level benefit requires the establishment of standardized validation methodologies, large-scale pragmatic trials with patient-centered outcomes, robust regulatory frameworks, and equitable implementation strategies addressing health disparities globally. Full article
(This article belongs to the Special Issue Colon and Rectal Surgery: Recent Advances and Future Trends)
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