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Robotic and laparoscopic TME match at five years in COLRAR; small-bite closure lowers incisional hernia; prehabilitation trial misses
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Five-year results of the COLRAR randomized trial, published Oct. 26 in BJS, showed similar survival after robotic and laparoscopic total mesorectal excision for rectal cancer.
A meta-analysis of 10 trials favored small-bite fascial closure, a Danish trial found preoperative exercise did not raise surgery rates in gastroesophageal cancer and the Centers for Medicare & Medicaid Services (CMS) finalized an organ procurement rule.
THE DETAILS
- Research Oct 26, 2026Five-year outcomes of the COLRAR randomized trial at three Korean centers, published Oct. 26 in BJS, showed similar overall survival (92.6% and 92.4%; P = .838) and relapse-free survival (81.9% and 83.0%; P = .801), both prespecified secondary end points, after laparoscopic and robotic total mesorectal excision. Local recurrence occurred in 4.9% after laparoscopy and 1.3% after robotic surgery, and local recurrence-free survival did not differ significantly (P = .076). A post hoc analysis of 146 patients given neoadjuvant chemoradiotherapy found five-year local recurrence-free survival of 98.6% with robotic and 90.7% with laparoscopic surgery (P = .039).
- Research Oct 26, 2026A meta-analysis with trial sequential analysis, published Oct. 26 in BJS, pooled 10 randomized trials with 2,617 patients comparing small-bite and large-bite closure of midline laparotomy. In the five studies using standardized clinical and imaging assessment, small-bite closure lowered incisional hernia (risk ratio 0.57; 95% CI 0.39 to 0.82; P = .003), and the benefit held in studies with at least 24 months of follow-up (risk ratio 0.56; 95% CI 0.36 to 0.89). Small-bite closure was also associated with fewer surgical site infections (risk ratio 0.72) and took 4.82 minutes longer.Sources: BJS, BJS (Oxford Academic abstract)
- Research Oct 28, 2026In the single-blinded PRESET randomized trial at Rigshospitalet in Copenhagen, published Oct. 28 in JAMA Network Open, twice-weekly aerobic and resistance training from diagnosis to surgery did not change the primary end point: 9.9% of the exercise group and 7.9% of controls did not undergo curative-intent surgery (odds ratio 1.28; 95% CI 0.48 to 3.38; P = .62). Postoperative complications did not differ. Three-year overall survival, a secondary end point, was 51.0% with exercise and 65.0% with usual care (hazard ratio 1.58; 95% CI 1.02 to 2.45).
- Policy Oct 30, 2026The Centers for Medicare & Medicaid Services (CMS) on Oct. 30 finalized a rule on organ procurement organizations (OPOs) that defines unsound medical practices so CMS can more clearly use its authority to decertify a noncompliant OPO, and requires OPOs to track organs sent for research. Pancreata procured only for islet cell research will no longer count toward an OPO's transplantation rate unless a transplant occurs. CMS said more than 100,000 Americans are waiting for transplants.Source: CMS
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