Outpatient Stoma Closure in 130 Patients. Insights From the GRECCAR Multicentric Study.

Objective: evaluate feasibility and outcomes of outpatient stoma closure.

Background: Stoma closure is a routine procedure still associated with prolonged hospital stays, despite a low complication rate. We hypothesized that it could be performed in an outpatient setting.

Association Between CD147 Expression, RAS Mutational Status, and Local Recurrence in Resected Locally Advanced Rectal Cancer.

Aim: About 5% to 10% of rectal cancer (RC) patients experience local disease recurrence after chemoradiotherapy (CRT) and surgery. Identifying patients at high risk of local recurrence (LR) could lead to the personalized management of the patients. Multiple clinicopathological parameters are associated with LR.

Laparoconversion for hemostasis during robotic surgery for complex deep endometriosis of sacral plexus and sciatic nerve does not avoid coming back to gasless robotic procedure.

Objective: To show that the laparoconversion in emergency due to intraoperative complications does not require to irreversibly abandon the robotic procedure.

Setting: Tertiary referral center PARTICIPANTS: A young patient with deep endometriosis involving the low rectum, both ureters with right hydronephrosis, the right sacral plexus and sciatic nerve, who underwent previous excision attempt 4 years earlier.

Intervention: The film summarizes a 10h complex surgical procedure of robotic excision of deep endometriosis.

Partial Responders to Neoadjuvant Therapy and the Risk of Distant Metastases: Longer Intervals to Definitive Resection Is Not a Risk Factor.

Background: The timing of resection after neoadjuvant therapy for rectal cancer remains a debated topic. Longer intervals from radiation completion have been associated with increased rates of clinical and pathological complete response, but concerns remain regarding partial responders and the risk of distant metastasis.

Objective: To evaluate whether the interval between the end of neoadjuvant chemoradiation therapy and surgical resection affects the development of distant metastases in patients with an excellent partial response.

Clinical contexts for Shared Decision-Making in rectal cancer: Organ preservation, sphincter-sparing surgery and tailored stoma policy.

The management of rectal cancer has evolved into a patient-centered multidisciplinary approach emphasizing oncological safety, quality of life (QoL), and functional outcomes. Shared Decision-Making (SDM) plays a pivotal role in navigating treatment strategies that balance these aspects. Rather than reviewing existing SDM interventions, this narrative review explores clinical situations where SDM could significantly support the decision-making process.

Predictors and risk model for positive circumferential resection margin after robot-assisted total mesorectal excision: retrospective cohort study.

Background: Positive circumferential resection margin (CRM) after total mesorectal excision (TME) is associated with higher local and systemic recurrence rates, affecting overall survival in patients with rectal cancer. Although risk factors for positive CRM have been identified for open, laparoscopic, and transanal TME, these may differ for robot-assisted total mesorectal excision (R-TME). This study aimed to assess the incidence of positive CRM following R-TME and identify the associated preoperative risk factors.

Management of Low Colorectal/Coloanal Anastomotic Leak: Results of a French National Intergroups Practice Survey (FRENCH-GRECCAR-SFCD).

Aims: Anastomotic leakage (AL) impacts short-term and long-term outcomes after colorectal surgery, yet no consensus exists regarding its diagnosis and management. The aim was to establish a proactive consensus-based approach for diagnosing and treating AL following rectal cancer surgery through a national survey.

Methods: A questionnaire was designed to assess 24 clinical scenarios related to the diagnosis and management of fistulas in low colorectal (LCA) or coloanal anastomosis (CAA) with a diverting ileostomy.

Routine Endoscopic Evaluation of Colorectal Anastomoses for Early Detection of Anastomotic Leakage (REAL Study): Protocol for a Multicenter Prospective Study.

Introduction: Early detection and timely treatment of anastomotic leakage (AL) following rectal surgery are crucial for improving outcomes. However, no standardized early detection pathway exists. This study evaluates a multicenter clinical care pathway integrating bedside endoscopy to reduce time to diagnose AL.

TreatmENT of AnastomotiC LeakagE after colon cancer resection: the TENTACLE - Colon study.

Background: Anastomotic leakage (AL) is a common and severe complication after colon cancer resection, but studies investigating various treatment strategies and factors influencing outcomes are scarce.

Objectives: (1) To identify predictive factors associated with 90-day mortality and 90-day Clavien-Dindo grade 4-5 complications amongst patients who developed AL following colon cancer resection with subsequent development and validation of prediction models, and (2) to explore and compare the effectiveness of various treatment strategies for AL following colon cancer resection, adjusting for type of index surgery, different leak entities and patient factors.

Methods: The TENTACLE - Colon is an international multicentre retrospective cohort study.

An International Multicentre Retrospective Cohort Study Evaluating Robot-Assisted Total Mesorectal Excision in Experienced Dutch, French, and United Kingdom Centres-The EUREKA Collaborative.

Background: Robot-assisted total mesorectal excision has been proposed as an alternative to laparoscopic TME for rectal cancer. However, its short-term outcomes and long-term oncological efficacy remain debated, especially in Western populations. This study evaluates the short-term clinical and long-term oncological outcomes of robot-assisted total mesorectal excision performed by experienced surgeons in high-volume European centres.

Ten years of robot-assisted versus laparoscopic total mesorectal excision for rectal cancer (short-term RESOLUTION).

Background: Total mesorectal excision is the gold standard for rectal cancer surgery, with laparoscopic and robot-assisted approaches commonly employed. While robot-assisted surgery may offer technical advantages, there is limited evidence comparing short-term outcomes of laparoscopic and robot-assisted techniques, particularly in Western European populations. This study aimed to assess the short-term outcomes of laparoscopic vs robot-assisted total mesorectal excision for rectal cancer.

Shared medical decision making.

Involving the patient in medical decision-making is called shared medical decision-making (SMD). While the concept of SMD is nothing new, implementation has been slow to develop within current clinical practice, although there is growing interest in this topic in the scientific literature. SMD requires full agreement with the patient, who becomes an actor in their own care, and whose goals sometimes differ from those of the doctor.

[Colorectal endometriosis surgery: Technical and technological innovations in service of a complex surgery].

Introduction: Digestive endometriosis represents the most common form of deep endometriosis, significantly impacting patients' quality of life. The optimization of its surgical management has been marked by major technological advances. This review explores the evolution of colorectal endometriosis surgery, highlighting the progress in laparoscopy, the contribution of robotics, the shift towards organ preservation, and the optimization of postoperative care.

Analysis of Local Recurrence After Robotic-Assisted Total Mesorectal Excision (ALRITE): An International, Multicentre, Retrospective Cohort.

Background/objectives: Rectal cancer is a major global health issue with high morbidity and mortality rates. Local recurrence (LR) significantly impacts patient outcomes, decreasing survival rates and often necessitating extensive secondary treatments. While robot-assisted total mesorectal excision (R-TME) is becoming a preferred method for rectal cancer surgery due to its improved precision and visualisation, long-term data on LR and predictors of recurrence remain limited.

Risk of distant metastasis after local excision for near-complete response versus salvage surgery for local regrowth in rectal cancer: Results from an international registry.

Aim: Watch and Wait (WW) strategy is currently used for mid/low rectal adenocarcinoma after neoadjuvant treatment (NAT). Local regrowth (LR) is a well-known risk, but its impact on distant metastasis (DM) is increasingly debated. This study aimed to assess the rate of DM after local excision (LE) for near-complete clinical response (ncCR) at restaging versus salvage surgery for regrowth following WW.

Long-term bowel function following delayed coloanal anastomosis: Analysis of a multicentric cohort study (GRECCAR).

Aim: Alteration of bowel function after delayed coloanal anastomosis (DCAA) might be a limitation to its utilization. Our aim was to assess the long-term bowel function of DCAA in a large multicentric cohort.

Method: All patients who underwent DCAA interventions at 29 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included.

Durable remission after ileocolic resection for Crohn's disease is achievable in selected patients. Long-term results of a prospective multicentric cohort study of the GETAID Chirurgie.

Background And Aims: Postoperative recurrence requiring medical treatment intensification or redo surgery is common after ileocolic resection (ICR) for Crohn's disease (CD). This study aimed to identify a subgroup of CD patients for whom ICR could achieve durable remission.

Methods: This retrospective follow-up study analyzed 592 CD patients who underwent ICR (2013-2015) in a nationwide prospective cohort.