Colorectal Surgery

Appendectomy, microbiota, and colorectal cancer: complex, context-dependent associations

This mini-review concludes appendectomy does not uniformly raise long-term colorectal cancer (CRC) risk and early postoperative signals may reflect detection bias or reverse causation. Mechanistic studies link appendectomy to shifts in gut microbiota, epithelial barrier function, inflammatory signaling, and tumor-associated macrophage programs. Effects appear to vary by time window, tumor location, and microbe-related molecular subtypes, notably Fusobacterium nucleatum-associated tumors. Clinical takeaway: interpret appendectomy–CRC associations as hypothesis-generating and not proof to change surgical indications. 1

Multicomponent lifestyle interventions improve behaviours and quality of life during CRC surveillance

Systematic review of 10 intervention studies in at‑above-average CRC risk patients found multicomponent programs improved diet, activity, and quality of life versus usual care. Interventions were commonly telephone-based or used health coaching and showed inconsistent effect sizes across studies. No trial reported effects on colorectal neoplasia incidence or CRC mortality. 2

CGA-based model predicts 90-day major adverse events after laparoscopic CRC resection

In patients ≥60 undergoing elective laparoscopic radical CRC resection, six preoperative CGA factors predicted 90-day major adverse postoperative events. The model showed good discrimination (AUC derivation 0.802, validation 0.779) with calibration and decision-curve support for clinical utility. Consider using the CGA tool to identify high-risk patients for targeted prehabilitation and perioperative planning. 3