2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Ta15,Robot-assisted minimally invasive oesophagectomy is used increasingly worldwide. However, no large-scale, multicentre, randomised controlled trial has compared long-term survival as the primary endpoint between robot-assisted oesophagectomy and conventional thoracoscopic oesophagectomy. We aimed to confirm the non-inferiority in overall survival of robot-assisted oesophagectomy over thoracoscopic oesophagectomy in patients with resectable oesophageal squamous cell carcinoma. This multicentre, open-label, randomised, controlled, phase 3, non-inferiority trial (RAMIE) was conducted at six hospitals in China. Patients aged 18-75 years, with biopsy-proven squamous cell carcinoma, Eastern Cooperative Oncology Group scores of 0-2, and with tumour and nodal classifications of cT1-4a, N0-2, M0, or M1 (supraclavicular lymph nodes metastasis) were eligible. Patients were randomly assigned (1:1) using a computer-generated randomisation list and stratified by neoadjuvant therapy to robot-assisted oesophagectomy or thoracoscopic oesophagectomy, both with at least two-field lymphadenectomy. The primary endpoint was overall survival, analysed in the intention-to-treat population. The non-inferiority margin was 9% for 5-year overall survival (the upper limit of 95% CI of the hazard ratio [HR] was 1·33). Harms were assessed in the per-protocol population, defined as all eligible participants undergoing resection. This trial was registered with ClinicalTrials.gov, number NCT03094351 and is completed. Between Aug 2, 2017, and Dec 23, 2019, 362 patients were randomly assigned (183 to robot-assisted oesophagectomy and 179 to thoracoscopic oesophagectomy. 309 (85%) of 362 patients were men and 53 (15%) were women. Two patients in each group did not undergo resection and were excluded from the per-protocol population. Median follow-up of the planned final analysis was 71·5 months (IQR 63·9-81·8). At 5 years, overall survival was 69·4% (95% CI 62·1-75·6) with robot-assisted oesophagectomy versus 56·2% (48·5-63·2) with thoracoscopic oesophagectomy (HR 0·71, 95% CI 0·51-0·97), confirming non-inferiority (one-sided p In patients with resectable oesophageal squamous cell carcinoma, robot-assisted oesophagectomy was non-inferior, and seemed superior, to thoracoscopic oesophagectomy in terms of 5-year overall survival. National Clinical Key Specialty Construction Project, Shanghai Hospital Development Center, and the Program of Shanghai Academic/Technology Research Leader. For the Chinese translation of the abstract see Supplementary Materials section.31:T827,Rural populations experience higher colon cancer (CC) mortality than urban populations, and rural patients may have more complications after resection. Reoperations due to complications after CC resection among rural and urban patients are not clear, and factors mediating disparities in rural-urban postoperative outcomes have not been examined. Using the Surveillance, Epidemiology, and End Results Program-Medicare database, individuals with CC who underwent surgical resection were compared via multivariable logistic regression to determine the association of rurality with postoperative complications and reoperations at 30, 60, and 90 days. A 4-way effect decomposition (mediation analysis) assessed how surgical approach (open vs minimally invasive surgery [MIS]) mediated the relationship between rurality and complication risk. Survival was assessed at 30 days, 90 days, and 1 year. Among 33,183 patients, rural patients (n = 5,938; 18%) had lower Charlson Comorbidity Indices (p < 0.0001) and presented less emergently (p = 0.0307); stage did not differ from urban patients. Rural patients underwent more postdischarge reoperations (p = 0.0007) and had higher odds of surgical site infection (SSI; odds ratio [OR] 1.31, 95% CI 1.13 to 1.52) and anastomotic leak (OR 1.19, 95% CI 1.07 to 1.33). Rural individuals were less likely to undergo MIS (OR 0.67, 95% CI 0.63 to 0.72); MIS was associated with lower odds of SSI (OR 0.58, 95% CI 0.51 to 0.67) and leak (OR 0.57, 95% CI 0.52 to 0.63). Surgical approach mediated 29% of the overall complication risk, 18% of the SSI risk, and 28% of the anastomotic leak risk for rural patients. Finally, survival was lower among rural patients (30 days: p = 0.0313; 90 days: p = 0.0195; 1 year: p = 0.0063). Surgical approach mediated one-third of the complication risk experienced by rural patients, who had higher odds of complications, more postdischarge reoperations, and lower odds of accessing MIS. Expanding rural MIS colectomy practices may be one way to achieve more geographically equitable outcomes.32:Ta80, BACKGROUND: Rural populations experience higher colon cancer (CC) mortality than urban populations, and rural patients may have more complications after resection. Reoperations due to complications after CC resection among rural and urban patients are not clear, and factors mediating disparities in rural–urban postoperative outcomes have not been examined. STUDY DESIGN: Using the Surveillance, Epidemiology, and End Results Program–Medicare database, individuals with CC who underwent surgical resection were compared via multivariable logistic regression to determine the association of rurality with postoperative complications and reoperations at 30, 60, and 90 days. A 4-way effect decomposition (mediation analysis) assessed how surgical approach (open vs minimally invasive surgery [MIS]) mediated the relationship between rurality and complication risk. Survival was assessed at 30 days, 90 days, and 1 year. RESULTS: Among 33,183 patients, rural patients (n = 5,938; 18%) had lower Charlson Comorbidity Indices (p < 0.0001) and presented less emergently (p = 0.0307); stage did not differ from urban patients. Rural patients underwent more postdischarge reoperations (p = 0.0007) and had higher odds of surgical site infection (SSI; odds ratio [OR] 1.31, 95% CI 1.13 to 1.52) and anastomotic leak (OR 1.19, 95% CI 1.07 to 1.33). Rural individuals were less likely to undergo MIS (OR 0.67, 95% CI 0.63 to 0.72); MIS was associated with lower odds of SSI (OR 0.58, 95% CI 0.51 to 0.67) and leak (OR 0.57, 95% CI 0.52 to 0.63). Surgical approach mediated 29% of the overall complication risk, 18% of the SSI risk, and 28% of the anastomotic leak risk for rural patients. Finally, survival was lower among rural patients (30 days: p = 0.0313; 90 days: p = 0.0195; 1 year: p = 0.0063). CONCLUSIONS: Surgical approach mediated one-third of the complication risk experienced by rural patients, who had higher odds of complications, more postdischarge reoperations, and lower odds of accessing MIS. Expanding rural MIS colectomy practices may be one way to achieve more geographically equitable outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Minimally Invasive Surgery: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Minimally Invasive Surgery (modality). Clinician-written summaries and actionable practice insights. 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Low ligation does not need to be routinely favored over high ligation on the basis of leak prevention alone."}},{"doi":"10.1002/jhbp.70135","pmid":"42186132","title":"Expert Survey on Chyle Leakage After Pancreaticoduodenectomy: The Precision Anatomy for Minimally Invasive Hepato‐Biliary‐Pancreatic Surgery (\n PAM\n ‐\n HBP\n Surgery) Project 2024","journal_title":"Journal of Hepato-Biliary-Pancreatic Sciences","journal_issn":"1868-6974","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1002/jhbp.70135","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-31T13:35:31.239Z","updated_at":"2026-05-31T13:35:31.239Z","tags":[{"paper_doi":"10.1002/jhbp.70135","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"condition","value":"Chyle Leakage","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"condition","value":"Pancreaticoduodenectomy Complications","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Minimally Invasive Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"sample_size","value":"n=57","value_numeric":57},{"paper_doi":"10.1002/jhbp.70135","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"study_design","value":"Expert Survey","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"Study design is an expert survey, which may overrepresent high-volume centers and may not reflect typical practice.","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"The 'level of evidence' is assigned as 5 (expert opinion) given the survey-based methodology.","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"The sample of 57 surgeons represents expert opinion only; no patient outcomes or incidence rates are quantified, limiting clinical applicability.","value_numeric":null}],"summaries":{"what_studied":"A structured expert survey of 57 surgeons from 10 countries examined the incidence, anatomical pitfalls, and surgical techniques related to chyle leakage (CL) after pancreaticoduodenectomy (PD), comparing open, laparoscopic, and robotic approaches.","key_result":"Experts reported CL incidence as open ≥ laparoscopic, open > robotic, and laparoscopic = robotic. Three key anatomical risk zones were identified: (i) transverse mesocolon at the ventral SMA/SMV, (ii) meso-jejunum at the dorsal SMA/SMV, and (iii) fusion fascia of Treitz at the ventral IVC. No consensus was reached on the optimal dissection plane at Treitz fascia (21% pancreatic surface, 31% within fascia, 38% IVC-exposing).","limitations":"Survey-based design captures expert opinion rather than objective outcome data; no patient-level data or incidence rates reported; potential selection bias toward high-volume, experienced surgeons.","practice_takeaway":"Focus lymphatic control at three key anatomical zones during PD—transverse mesocolon, meso-jejunum, and Treitz fascia—using energy devices as the preferred modality across all surgical approaches. Robotic PD may carry a lower CL risk than open surgery per expert consensus, though prospective data are lacking."}},{"doi":"10.1001/jamasurg.2026.1503","pmid":"42160093","title":"Activity and Physiological Stress Within 90 Days After Minimally Invasive and Open Pancreatoduodenectomy","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-05-20T00:00:00.000Z","url":"https://doi.org/10.1001/jamasurg.2026.1503","source_score":9,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:34:50.042Z","updated_at":"2026-05-26T13:34:50.042Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"condition","value":"Pancreatic Neoplasm","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"condition","value":"Periampullary Neoplasm","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"modality","value":"Minimally Invasive Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"sample_size","value":"n=288","value_numeric":288},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"warning","value":"HRV as a proxy for physiological stress/recovery is an indirect measure; clinical significance of a 9 ms difference is not firmly established in this surgical context.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"warning","value":"The 2:1 randomization ratio (MIPD:OPD) means the OPD group (n=81 with tracker data) is notably smaller, which may reduce precision for OPD subgroup estimates.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"warning","value":"The paper is dated May 2026, which is recent; findings have not yet been replicated in lower-volume or non-European centers, as the authors themselves note.","value_numeric":null}],"summaries":{"what_studied":"The DIPLOMA-2 RCT compared postoperative recovery after minimally invasive pancreatoduodenectomy (MIPD) vs. open pancreatoduodenectomy (OPD) in 288 patients with upfront resectable pancreatic head or periampullary neoplasms across 14 high-volume European centers, using wearable activity trackers (Fitbit Inspire 2) from 2 weeks pre-op through 90 days post-op.","key_result":"At postoperative day 30, MIPD patients averaged **659 more daily steps** (95% CI, 79–1240; P=.03), **22 more active minutes/day** (95% CI, 3–40; P=.03), and **9 ms higher HRV** (95% CI, 2–15; P=.006) vs. OPD. Step count and active minutes equalized by day 90, but HRV remained higher in the MIPD group through 3 months.","limitations":"- Only 82% of enrolled patients had usable tracker data, introducing potential selection bias.\n- All centers were high-volume European sites, limiting generalizability to lower-volume or non-European settings.\n- Activity differences between groups were modest and equalized by day 90 for most measures.","practice_takeaway":"MIPD offers a meaningful but time-limited recovery advantage over OPD — more activity and less physiological stress for roughly the first 5 weeks post-discharge. For eligible patients at high-volume centers, MIPD appears to support a faster return to physical function, though longer-term differences beyond 90 days remain unclear."}},{"doi":"10.1016/s2468-1253(25)00402-9","pmid":"41932350","title":"Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial","journal_title":"The Lancet Gastroenterology & Hepatology","journal_issn":"2468-1253","published_at":"2026-04-04T00:00:00.000Z","url":"https://doi.org/10.1016/s2468-1253(25)00402-9","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1016/s2468-1253(25)00402-9","days":"7","issn":"2468-1253","rank":"10","field":"Clinical Medicine","score":"5","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1016/S2468-1253(25)00402-9","title":"Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial.","journal":"The lancet. Gastroenterology & hepatology","methods":"","results":"","abstract":"$30","keywords":[],"pubmed_id":"41932350","conclusions":"","publication_date":"2026-04-04T00:00:00"},"crossref":{"DOI":"10.1016/s2468-1253(25)00402-9","URL":"https://doi.org/10.1016/s2468-1253(25)00402-9","ISSN":["2468-1253"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S2468125325004029?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S2468125325004029?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"452-462","type":"journal-article","issue":"6","score":1,"title":["Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority 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populations.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(25)00402-9","tag_type":"warning","value":"One-sided p-value for non-inferiority is truncated in the abstract.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(25)00402-9","tag_type":"warning","value":"The superiority finding (p=0.032) was an exploratory post-hoc analysis — the trial was powered and designed for non-inferiority only; caution is warranted in interpreting this as definitive superiority evidence.","value_numeric":null},{"paper_doi":"10.1016/s2468-1253(25)00402-9","tag_type":"warning","value":"Trial was conducted at six specialised Chinese centres; generalisability to lower-volume or non-Asian centres is uncertain.","value_numeric":null}],"summaries":{"what_studied":"A multicentre, open-label, randomised phase 3 non-inferiority trial at six hospitals in China compared robot-assisted with thoracoscopic minimally invasive oesophagectomy for resectable oesophageal squamous cell carcinoma. Adults aged 18–75 years (cT1–4a, N0–2, M0 or M1 with supraclavicular nodes) were randomised 1:1, stratified by neoadjuvant therapy; the primary endpoint was 5-year overall survival with a median follow-up of 71.5 months.","key_result":"At 5 years, overall survival was 69.4% (95% CI 62.1–75.6) with robot-assisted versus 56.2% (48.5–63.2) with thoracoscopic oesophagectomy; HR 0.71 (95% CI 0.51–0.97), meeting non-inferiority.","limitations":"Open-label design; all centres were in China, limiting generalisability; findings apply to squamous histology only.","practice_takeaway":"For resectable oesophageal squamous cell carcinoma, robot-assisted oesophagectomy provides at least non-inferior 5-year survival versus thoracoscopic surgery and may be superior."}},{"doi":"10.1097/xcs.0000000000001601","pmid":"40928080","title":"Surgical Approach as a Mediator of Rural–Urban Disparity after Colon Cancer Resection","journal_title":"Journal of the American College of Surgeons","journal_issn":"1072-7515","published_at":"2025-09-10T00:00:00.000Z","url":"https://doi.org/10.1097/xcs.0000000000001601","source_score":46,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-19","doi":"10.1097/xcs.0000000000001601","days":"7","issn":"1072-7515","rank":"5","field":"Clinical Medicine","score":"46","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1097/XCS.0000000000001601","title":"Surgical Approach as a Mediator of Rural-Urban Disparity after Colon Cancer Resection.","journal":"Journal of the American College of Surgeons","methods":"","results":"Among 33,183 patients, rural patients (n = 5,938; 18%) had lower Charlson Comorbidity Indices (p < 0.0001) and presented less emergently (p = 0.0307); stage did not differ from urban patients. Rural patients underwent more postdischarge reoperations (p = 0.0007) and had higher odds of surgical site infection (SSI; odds ratio [OR] 1.31, 95% CI 1.13 to 1.52) and anastomotic leak (OR 1.19, 95% CI 1.07 to 1.33). Rural individuals were less likely to undergo MIS (OR 0.67, 95% CI 0.63 to 0.72); MIS was associated with lower odds of SSI (OR 0.58, 95% CI 0.51 to 0.67) and leak (OR 0.57, 95% CI 0.52 to 0.63). Surgical approach mediated 29% of the overall complication risk, 18% of the SSI risk, and 28% of the anastomotic leak risk for rural patients. Finally, survival was lower among rural patients (30 days: p = 0.0313; 90 days: p = 0.0195; 1 year: p = 0.0063).","abstract":"$31","keywords":[],"pubmed_id":"40928080","conclusions":"","publication_date":"2025-09-10T00:00:00"},"crossref":{"DOI":"10.1097/xcs.0000000000001601","URL":"https://doi.org/10.1097/xcs.0000000000001601","ISSN":["1072-7515","1879-1190"],"link":[{"URL":"https://journals.lww.com/10.1097/XCS.0000000000001601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"432-443","type":"journal-article","issue":"2","score":1,"title":["Surgical Approach as a Mediator of Rural–Urban Disparity after Colon Cancer Resection"],"author":[{"given":"Sara","family":"Myers","sequence":"first","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Davis, Murillo, Ng, Sachs, Davids, Kenzik)"},{"name":"Department of Surgery, 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Kenzik)"}]},{"given":"Teviah","family":"Sachs","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Davis, Murillo, Ng, Sachs, Davids, Kenzik)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Sachs, Davids, Kenzik)"}]},{"given":"Jennifer S","family":"Davids","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Davis, Murillo, Ng, Sachs, Davids, Kenzik)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Sachs, Davids, Kenzik)"}]},{"given":"Kelly M","family":"Kenzik","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Davis, Murillo, Ng, Sachs, Davids, Kenzik)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Sachs, Davids, Kenzik)"},{"name":"Department of Surgery, Slone Epidemiology Center, Boston University, Boston, MA 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complications and reoperations, and tested whether surgical approach (open vs minimally invasive surgery) mediated disparities; survival was assessed to 1 year.","key_result":"Among 33,183 patients (rural n=5,938; 18%), rural patients had higher odds of surgical site infection (OR 1.31, 95% CI 1.13–1.52) and anastomotic leak (OR 1.19, 95% CI 1.07–1.33), more postdischarge reoperations (p=0.0007), and were less likely to receive minimally invasive surgery (MIS) (OR 0.67, 95% CI 0.63–0.72). MIS was linked to lower odds of SSI (OR 0.58, 95% CI 0.51–0.67) and leak (OR 0.57, 95% CI 0.52–0.63); surgical approach mediated 29% of overall complication risk, 18% of SSI risk, and 28% of leak risk, and survival was lower for rural patients at 30 days (p=0.0313), 90 days (p=0.0195), and 1 year (p=0.0063).","practice_takeaway":"Rural patients had less access to MIS and more complications; because MIS was associated with fewer infections and leaks and mediated roughly one-third of the disparity, expanding access to MIS colectomy in rural settings may help narrow postoperative outcome gaps."}}],"initialOffset":5,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Minimally Invasive Surgery"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Minimally Invasive Surgery"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Minimally Invasive Surgery"}}}]]

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