{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:31:42Z","timestamp":1787927502369,"version":"build-2784847793"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Effective surgical therapy of rectal cancer necessitates meticulous selection of suitable surgical procedures contingent upon tumour location, stage and patient characteristics. This research examines surgical procedural trends and results in a tertiary care facility in Kashmir.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n A 7-year retrospective\u2013prospective research examined 510 rectal cancer patients who had surgical treatment at SKIMS. Surgical interventions were classified as local excision, low anterior resection (LAR), abdominoperineal resection (APR), Hartmann\u2019s technique and palliative operations. Data about surgical approaches (open, laparoscopic and robotic), perioperative parameters and complications were gathered and analysed.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Out of 510 patients, 36 (7.05%) had transanal excision, 280 (54.9%) underwent LAR, 145 (28.4%) received APR, 35 (6.9%) were treated with Hartmann\u2019s surgery and 14 (2.7%) had unresectable disease necessitating palliative interventions. In the cohort undergoing neoadjuvant treatment, the rates of sphincter-preserving surgery were significantly elevated (62.5% compared to 45.1%,\n P<\/jats:italic>\n < 0.05). A laparoscopic technique was employed in 178 individuals (34.9%). Conversion to open surgery was performed in 18 instances (10.1%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This institutional experience illustrates the progression of surgical practices, highlighting the growing implementation of sphincter-preserving techniques and less invasive methods. Neoadjuvant treatment profoundly impacts surgical decision-making, facilitating an increased number of sphincter-preserving surgeries. Persistent focus on entire mesorectal excision principles and judicious application of sophisticated surgical methods can enhance oncological and functional results.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmas.jmas_91_26","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:06:41Z","timestamp":1787926001000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of rectal cancer: Analysis of procedural patterns and perioperative outcomes in 510 patients"],"prefix":"10.4103","author":[{"given":"Amir Zaffar","family":"Lone","sequence":"first","affiliation":[{"name":"Department of General and Minimal Invasive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehraj Ul Islam","family":"Teeli","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fazl-Ul-Qadir","family":"Parray","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Batool","sequence":"additional","affiliation":[{"name":"Department of General and Minimal Invasive Surgery, Government Medical College, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran Salam","family":"Teeli","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qadar Un","family":"Nisaa","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zubair","family":"Gani","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"R1-20260828","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.6004\/jnccn.2022.0051","article-title":"Rectal cancer, version 2.2022, NCCN clinical practice guidelines in oncology","volume":"20","author":"Benson","year":"2022","journal-title":"J Natl Compr Canc Netw"},{"key":"R2-20260828","doi-asserted-by":"crossref","first-page":"iv22","DOI":"10.1093\/annonc\/mdx224","article-title":"Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"28","author":"Glynne-Jones","year":"2017","journal-title":"Ann Oncol"},{"key":"R3-20260828","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/S0140-6736(86)91510-2","article-title":"Recurrence and survival after total mesorectal excision for rectal cancer","volume":"1","author":"Heald","year":"1986","journal-title":"Lancet"},{"key":"R4-20260828","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1055\/s-0039-3402776","article-title":"Total mesorectal excision technique-past, present, and future","volume":"33","author":"Knol","year":"2020","journal-title":"Clin Colon Rectal Surg"},{"key":"R5-20260828","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.3748\/wjg.14.3281","article-title":"Surgical treatment for rectal cancer: An international perspective on what the medical gastroenterologist needs to know","volume":"14","author":"Lindsetmo","year":"2008","journal-title":"World J Gastroenterol"},{"key":"R6-20260828","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1002\/bjs.7160","article-title":"Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer","volume":"97","author":"Jayne","year":"2010","journal-title":"Br J Surg"},{"key":"R7-20260828","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1001\/jama.2015.12009","article-title":"Effect of laparoscopic-assisted resection versus open resection on pathological outcomes in rectal cancer: The ALaCaRT randomized clinical trial","volume":"314","author":"Stevenson","year":"2015","journal-title":"JAMA"},{"key":"R8-20260828","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S1470-2045(13)70016-0","article-title":"Laparoscopic versus open surgery for rectal cancer (COLOR II): Short-term outcomes of a randomised, phase 3 trial","volume":"14","author":"van der Pas","year":"2013","journal-title":"Lancet Oncol"},{"key":"R9-20260828","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S1470-2045(10)70131-5","article-title":"Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): Short-term outcomes of an open-label randomised controlled trial","volume":"11","author":"Kang","year":"2010","journal-title":"Lancet Oncol"},{"key":"R10-20260828","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1056\/NEJMoa040694","article-title":"Preoperative versus postoperative chemoradiotherapy for rectal cancer","volume":"351","author":"Sauer","year":"2004","journal-title":"N Engl J Med"},{"key":"R11-20260828","doi-asserted-by":"crossref","first-page":"5124","DOI":"10.1200\/JCO.2009.22.0467","article-title":"Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03","volume":"27","author":"Roh","year":"2009","journal-title":"J Clin Oncol"},{"key":"R12-20260828","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/S1470-2045(10)70172-8","article-title":"Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: A pooled analysis of individual patient data","volume":"11","author":"Maas","year":"2010","journal-title":"Lancet Oncol"},{"key":"R13-20260828","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1016\/S0140-6736(18)31078-X","article-title":"Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the international watch and wait database (IWWD): An international multicentre registry study","volume":"391","author":"van der Valk","year":"2018","journal-title":"Lancet"},{"key":"R14-20260828","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1007\/s10350-005-0134-5","article-title":"Technique and long-term results of intersphincteric resection for low rectal cancer","volume":"48","author":"Schiessel","year":"2005","journal-title":"Dis Colon Rectum"},{"key":"R15-20260828","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0360-3016(99)00099-1","article-title":"Tumor downstaging and sphincter preservation with preoperative chemoradiation in locally advanced rectal cancer: The M. D. Anderson cancer center experience","volume":"44","author":"Janjan","year":"1999","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R16-20260828","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1200\/JCO.2011.40.1836","article-title":"Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: Results of the German CAO\/ARO\/AIO-94 randomized phase III trial after a median follow-up of 11 years","volume":"30","author":"Sauer","year":"2012","journal-title":"J Clin Oncol"},{"key":"R17-20260828","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.jamcollsurg.2015.04.010","article-title":"Extended intervals after neoadjuvant therapy in locally advanced rectal cancer: The key to improved tumor response and potential organ preservation","volume":"221","author":"Probst","year":"2015","journal-title":"J Am Coll Surg"},{"key":"R18-20260828","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1111\/codi.15263","article-title":"Abdominoperineal excision in Australasia: Clinical outcomes, predictive factors and recent trends of nonrestorative rectal cancer surgery","volume":"22","author":"Smith","year":"2020","journal-title":"Colorectal Dis"},{"key":"R19-20260828","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/SLA.0b013e3181ad6511","article-title":"Laparoscopic versus open surgery for rectal cancer: Long-term oncologic results","volume":"250","author":"Laurent","year":"2009","journal-title":"Ann Surg"},{"key":"R20-20260828","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1002\/bjs.6662","article-title":"Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer","volume":"96","author":"Lujan","year":"2009","journal-title":"Br J Surg"},{"key":"R21-20260828","first-page":"89","article-title":"COLOR II. A randomized clinical trial comparing laparoscopic and open surgery for rectal cancer","volume":"56","author":"Buunen","year":"2009","journal-title":"Dan Med Bull"},{"key":"R22-20260828","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/S1470-2045(14)70205-0","article-title":"Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): Survival outcomes of an open-label, non-inferiority, randomised controlled trial","volume":"15","author":"Jeong","year":"2014","journal-title":"Lancet Oncol"},{"key":"R23-20260828","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1097\/SLA.0b013e318155a762","article-title":"Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial","volume":"246","author":"Fleshman","year":"2007","journal-title":"Ann Surg"},{"key":"R24-20260828","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12893-025-02769-0","article-title":"Short-term outcomes of open versus laparoscopic surgery in patients with metachronous colorectal cancer","volume":"25","author":"Li","year":"2025","journal-title":"BMC Surg"},{"key":"R25-20260828","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.3390\/biomedicines13102570","article-title":"Aretrospective study regarding the implementation of laparoscopy in colon cancer through the evaluation of lymph node yield and oncological safety margins in a medium-volume center in Eastern Europe","volume":"13","author":"Slavu","year":"2025","journal-title":"Biomedicines"},{"key":"R26-20260828","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1002\/bjs.6456","article-title":"A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer","volume":"96","author":"Bach","year":"2009","journal-title":"Br J Surg"},{"key":"R27-20260828","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1007\/DCR.0b013e3181a1d8c9","article-title":"Emergency first presentation of colorectal cancer predicts significantly poorer outcomes: A review of 356 consecutive Irish patients","volume":"52","author":"Bass","year":"2009","journal-title":"Dis Colon Rectum"},{"key":"R28-20260828","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1136\/gutjnl-2014-308074","article-title":"Faecal immunochemical tests versus guaiac faecal occult blood tests: What clinicians and colorectal cancer screening programme organisers need to know","volume":"64","author":"Tinmouth","year":"2015","journal-title":"Gut"},{"key":"R29-20260828","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/00000478-200202000-00004","article-title":"Lymph node recoveries from 2427 pT3 colorectal resection specimens spanning 45 years: Recommendations for a minimum number of recovered lymph nodes based on predictive probabilities","volume":"26","author":"Goldstein","year":"2002","journal-title":"Am J Surg Pathol"},{"key":"R30-20260828","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1046\/j.0007-1323.2001.02024.x","article-title":"Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer","volume":"89","author":"Wibe","year":"2002","journal-title":"Br J Surg"},{"key":"R31-20260828","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1200\/JCO.2007.12.7027","article-title":"What is the role for the circumferential margin in the modern treatment of rectal cancer?","volume":"26","author":"Nagtegaal","year":"2008","journal-title":"J Clin Oncol"},{"key":"R32-20260828","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1200\/JCO.2011.39.7901","article-title":"Neoadjuvant treatment response as an early response indicator for patients with rectal cancer","volume":"30","author":"Park","year":"2012","journal-title":"J Clin Oncol"},{"key":"R33-20260828","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.1200\/JCO.2010.33.1595","article-title":"Nomograms for predicting local recurrence, distant metastases, and overall survival for patients with locally advanced rectal cancer on the basis of European randomized clinical trials","volume":"29","author":"Valentini","year":"2011","journal-title":"J Clin Oncol"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_91_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T14:06:45Z","timestamp":1787926005000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_91_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":33,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_91_26","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"assertion":[{"value":"2026-02-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}