{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:42:42Z","timestamp":1763145762119,"version":"3.45.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The University of Osaka"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early postoperative small bowel obstruction (EPSBO) is a common complication after colorectal cancer surgery, even with minimally invasive techniques. While anti-adhesion agents are used, effective intraoperative strategies remain limited. We evaluated whether manually repositioning the small bowel and omentum to their anatomical positions (Technique R) at the end of surgery reduces the risk of EPSBO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a two-center, retrospective, propensity score-matched cohort study including 1351 patients who underwent laparoscopic or robot-assisted colorectal cancer surgery between January 2015 and March 2024. Patients were divided into Group A (prior to Technique R,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009770) and Group B (after adoption of Technique R,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009581). One-to-one propensity score matching yielded 488 matched pairs. The primary outcome was the incidence of EPSBO within 30 postoperative days. Multivariate logistic regression was performed to identify independent predictors of EPSBO.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      EPSBO occurred in 4.5% of patients in Group A and 1.4% in Group B (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). In multivariate analysis, the omission of Technique R was identified as an independent risk factor (odds ratio [OR]: 3.09; 95% confidence interval [CI] 1.23\u20137.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), along with stoma creation (OR: 4.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and intra-abdominal abscess (OR: 2.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). Technique R was not associated with increased operative time or intraoperative complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Omission of Technique R was independently associated with a threefold increase in EPSBO risk. Technique R is a simple, safe, and effective maneuver that significantly improves postoperative outcomes after minimally invasive colorectal surgery and should be considered as a standard operative step.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12179-1","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:56:48Z","timestamp":1760367408000},"page":"7789-7797","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Manual repositioning of the small bowel and omentum prevents early postoperative small bowel obstruction after laparoscopic colorectal surgery: a propensity score-matched study"],"prefix":"10.1007","volume":"39","author":[{"given":"Mitsunobu","family":"Takeda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-5619","authenticated-orcid":false,"given":"Mamoru","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsunekazu","family":"Mizushima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoma","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Sekido","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Hata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Hamabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Ogino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norikatsu","family":"Miyoshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Takemasa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Doki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetoshi","family":"Eguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"issue":"6","key":"12179_CR1","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1002\/bjs.4589","volume":"91","author":"SB Sajja","year":"2004","unstructured":"Sajja SB, Schein M (2004) Early postoperative small bowel obstruction. Br J Surg 91(6):683\u2013691","journal-title":"Br J Surg"},{"issue":"1","key":"12179_CR2","first-page":"70","volume":"14","author":"B Ahmad","year":"2024","unstructured":"Ahmad B, Haq MFU, Shah MA, Parray FQ, Bhat GA, Wani RA (2024) Early postoperative small bowel obstruction after colorectal surgery: incidence and exploratory analysis of potential risk factors. Euroasian J Hepatogastroenterol 14(1):70\u201374","journal-title":"Euroasian J Hepatogastroenterol"},{"issue":"4","key":"12179_CR3","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S2468-1253(16)30207-2","volume":"2","author":"S Kitano","year":"2017","unstructured":"Kitano S, Inomata M, Mizusawa J, Katayama H, Watanabe M, Yamamoto S et al (2017) Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol 2(4):261\u2013268","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"1","key":"12179_CR4","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1007\/s00464-017-5681-z","volume":"32","author":"E Hain","year":"2018","unstructured":"Hain E, Maggiori L, Mongin C, la Denise Prost A, J, Panis Y. (2018) Risk factors for prolonged postoperative ileus after laparoscopic sphincter-saving total mesorectal excision for rectal cancer: an analysis of 428 consecutive patients. Surg Endosc 32(1):337\u201344","journal-title":"Surg Endosc"},{"issue":"6","key":"12179_CR5","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1002\/ags3.12705","volume":"7","author":"S Fujiyoshi","year":"2023","unstructured":"Fujiyoshi S, Homma S, Yoshida T, Ichikawa N, Shibata K, Matsui H et al (2023) A study of risk factors of postoperative ileus after laparoscopic colorectal resection. Ann Gastroenterol Surg 7(6):949\u2013954","journal-title":"Ann Gastroenterol Surg"},{"issue":"2","key":"12179_CR6","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s00464-015-4247-1","volume":"30","author":"Z Moghadamyeghaneh","year":"2016","unstructured":"Moghadamyeghaneh Z, Hwang GS, Hanna MH, Phelan M, Carmichael JC, Mills S et al (2016) Risk factors for prolonged ileus following colon surgery. Surg Endosc 30(2):603\u2013609","journal-title":"Surg Endosc"},{"issue":"1","key":"12179_CR7","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1097\/SLA.0b013e3181fcb83e","volume":"253","author":"U Kronberg","year":"2011","unstructured":"Kronberg U, Kiran RP, Soliman MS, Hammel JP, Galway U, Coffey JC et al (2011) A characterization of factors determining postoperative ileus after laparoscopic colectomy enables the generation of a novel predictive score. Ann Surg 253(1):78\u201381","journal-title":"Ann Surg"},{"issue":"9","key":"12179_CR8","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1007\/s10350-004-6395-6","volume":"45","author":"SH Ellozy","year":"2002","unstructured":"Ellozy SH, Harris MT, Bauer JJ, Gorfine SR, Kreel I (2002) Early postoperative small-bowel obstruction: a prospective evaluation in 242 consecutive abdominal operations. Dis Colon Rectum 45(9):1214\u20131217","journal-title":"Dis Colon Rectum"},{"issue":"8","key":"12179_CR9","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1089\/lap.2014.0039","volume":"24","author":"CH Kim","year":"2014","unstructured":"Kim CH, Joo JK, Kim HR, Kim YJ (2014) The incidence and risk of early postoperative small bowel obstruction after laparoscopic resection for colorectal cancer. J Laparoendosc Adv Surg Tech A 24(8):543\u2013549","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"5","key":"12179_CR10","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1007\/s00268-010-0462-z","volume":"34","author":"J Nakajima","year":"2010","unstructured":"Nakajima J, Sasaki A, Otsuka K, Obuchi T, Nishizuka S, Wakabayashi G (2010) Risk factors for early postoperative small bowel obstruction after colectomy for colorectal cancer. World J Surg 34(5):1086\u20131090","journal-title":"World J Surg"},{"issue":"11","key":"12179_CR11","doi-asserted-by":"publisher","first-page":"3054","DOI":"10.1177\/00031348241260275","volume":"90","author":"SH Emile","year":"2024","unstructured":"Emile SH, Horesh N, Garoufalia Z, Gefen R, Zhou P, Dasilva G et al (2024) Predictors and impact of ileus on outcomes after laparoscopic right colectomy: a case-control study. Am Surg 90(11):3054\u20133060","journal-title":"Am Surg"},{"issue":"1","key":"12179_CR12","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12957-023-03265-6","volume":"21","author":"F Guo","year":"2023","unstructured":"Guo F, Sun Z, Wang Z, Gao J, Pan J, Zhang Q et al (2023) Nomogram for predicting prolonged postoperative ileus after laparoscopic low anterior resection for rectal cancer. World J Surg Oncol 21(1):380","journal-title":"World J Surg Oncol"},{"issue":"9","key":"12179_CR13","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1007\/s00595-023-02674-0","volume":"53","author":"K Honjo","year":"2023","unstructured":"Honjo K, Kawai M, Tsuchiya Y, Ro H, Sugimoto K, Takahashi M et al (2023) Risk factors for small-bowel obstruction after colectomy for colorectal cancer: a retrospective study. Surg Today 53(9):1038\u20131046","journal-title":"Surg Today"},{"issue":"10","key":"12179_CR14","doi-asserted-by":"publisher","first-page":"2287","DOI":"10.1007\/s00268-008-9652-3","volume":"32","author":"JY Shin","year":"2008","unstructured":"Shin JY, Hong KH (2008) Risk factors for early postoperative small-bowel obstruction after colectomy in colorectal cancer. World J Surg 32(10):2287\u20132292","journal-title":"World J Surg"},{"issue":"1","key":"12179_CR15","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1159\/000468155","volume":"35","author":"XJ Wang","year":"2018","unstructured":"Wang XJ, Chi P, Lin HM, Lu XR, Huang Y, Xu ZB et al (2018) Risk factors for early postoperative small bowel obstruction after elective colon cancer surgery: an observational study of 1,244 consecutive patients. Dig Surg 35(1):49\u201354","journal-title":"Dig Surg"},{"issue":"4","key":"12179_CR16","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1097\/GCO.0000000000000471","volume":"30","author":"C Arvizo","year":"2018","unstructured":"Arvizo C, Mehta ST, Yunker A (2018) Adverse events related to Trendelenburg position during laparoscopic surgery: recommendations and review of the literature. Curr Opin Obstet Gynecol 30(4):272\u2013278","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"9","key":"12179_CR17","first-page":"1001","volume":"85","author":"T Onodera","year":"1984","unstructured":"Onodera T, Goseki N, Kosaki G (1984) Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 85(9):1001\u20131005","journal-title":"Nihon Geka Gakkai Zasshi"},{"issue":"4","key":"12179_CR18","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1007\/s00384-016-2502-0","volume":"31","author":"A Emmanuel","year":"2016","unstructured":"Emmanuel A, Haji A (2016) Complete mesocolic excision and extended (D3) lymphadenectomy for colonic cancer: is it worth that extra effort? A review of the literature. Int J Colorectal Dis 31(4):797\u2013804","journal-title":"Int J Colorectal Dis"},{"key":"12179_CR19","unstructured":"Z\u00fchlke HV, Lorenz EM, Straub EM, Savvas V. [Pathophysiology and classification of adhesions]. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 1990:1009\u201316"},{"key":"12179_CR20","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.583422","volume":"11","author":"E Mazzotta","year":"2020","unstructured":"Mazzotta E, Villalobos-Hernandez EC, Fiorda-Diaz J, Harzman A, Christofi FL (2020) Postoperative ileus and postoperative gastrointestinal tract dysfunction: pathogenic mechanisms and novel treatment strategies beyond colorectal enhanced recovery after surgery protocols. Front Pharmacol 11:583422","journal-title":"Front Pharmacol"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12179-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-12179-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12179-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:36:45Z","timestamp":1763145405000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-12179-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["12179"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-12179-1","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"type":"print","value":"0930-2794"},{"type":"electronic","value":"1432-2218"}],"subject":[],"published":{"date-parts":[[2025,10,13]]},"assertion":[{"value":"4 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Mitsunobu Takeda, Mamoru Uemura, Tsunekazu Mizushima, Shoma Yoshida, Takuya Inoue, Yuki Sekido, Tsuyoshi Hata, Atsushi Hamabe, Takayuki Ogino, Norikatsu Miyoshi, Hidetoshi Eguchi, and Yuichiro Doki have no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Approval of the research protocol: This study is approved by the Ethics Committee of Osaka International Medical & Science Center (Osaka Keisatsu Hospital) (1374) and conforms to the provisions of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All informed consent was obtained from the participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"N\/A","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human and animal participants"}}]}}