Annals of Coloproctology

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Stoma

Comparison of purse-string technique versus linear suture for skin closure after stoma reversal: a meta-analysis of high-quality studies: Filippo Carannante, Guglielmo Niccolò Piozzi, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Vincenzo Schiavone, Jim S. Khan, Marco Caricato, Gabriella Teresa Capolupo; Ann Coloproctol. 2025;41(6):491-500. Published online December 31, 2025; DOI: https://doi.org/10.3393/ac.2025.00801.0114

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Abstract PDF: Purpose
Stoma reversal is associated with notable postoperative morbidity. Several techniques exist for skin closure after stoma reversal, with linear primary closure (LC) and purse-string closure (PS) being the most common. This systematic review and meta-analysis aim to compare LC and PS skin closure after stoma reversal in terms of surgical site infection (SSI) rates, wound healing, and cosmesis.
Methods
In accordance with the PRISMA statement, a systematic review of skin closure after stoma reversal was conducted using MEDLINE (PubMed), Embase, Web of Science, and Scopus.
Results
Eleven studies, enrolling 1,052 patients (PS, n=534; LC, n=518), published between 2006 and 2024, were included. The overall quality of the studies was considered acceptable, with a mean Jadad scale score of 4 (range, 3–5). Patients underwent ileostomy or ileostomy/colostomy in 6 and 5 studies, respectively. No differences were observed between groups in operative time, length of hospital stay, intestinal obstruction, or incisional hernia. However, SSI and overall infection rates were higher in the LC group, with a statistically significant difference for SSI.
Conclusion
Skin closure following stoma reversal using the PS technique may offer advantages over LC. PS is associated with significantly lower SSI rates compared to LC. Although a large randomized controlled trial with long-term follow-up is still required, current findings suggest that PS could be considered the standard of care for wound closure after ileostomy reversal.

Minimally invasive surgery

Robotic colorectal surgery training: Portsmouth perspective: Guglielmo Niccolò Piozzi, Sentilnathan Subramaniam, Diana Ronconi Di Giuseppe, Rauand Duhoky, Jim S. Khan; Ann Coloproctol. 2024;40(4):350-362. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00444.0063

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7 Web of Science
7 Citations

Abstract PDF

This study aims to discuss the principles and pillars of robotic colorectal surgery training and share the training pathway at Portsmouth Hospitals University NHS Trust. A narrative review is presented to discuss all the relevant and critical steps in robotic surgical training. Robotic training requires a stepwise approach, including theoretical knowledge, case observation, simulation, dry lab, wet lab, tutored programs, proctoring (in person or telementoring), procedure-specific training, and follow-up. Portsmouth Colorectal has an established robotic training model with a safe stepwise approach that has been demonstrated through perioperative and oncological results. Robotic surgery training should enable a trainee to use the robotic platform safely and effectively, minimize errors, and enhance performance with improved outcomes. Portsmouth Colorectal has provided such a stepwise training program since 2015 and continues to promote and augment safe robotic training in its field. Safe and efficient training programs are essential to upholding the optimal standard of care.

Citations

Citations to this article as recorded by

Technical proficiency assessment of robotic intracorporeal single-stapling colorectal anastomosis using video-based RA-CUSUM
Shih-Feng Huang, Yung-Lin Tan, Chao-Wen Hsu, Hsin-Ping Tseng, Danilo Miskovic, Chih-Chien Wu
International Journal of Colorectal Disease.2026;[Epub] CrossRef
Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
Engeng Chen, Li Chen, Wei Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Entwicklung und Implementation eines strukturierten Ausbildungsprogramms in der robotischen Chirurgie
Sarah Englert, Natascha Tschukewitsch, Alexa Wölfl, Christoph Justinger
Die Chirurgie.2025; 96(9): 765. CrossRef
The evolution of training in robotic colorectal surgery
R. Smyth, N. Francis, S. Vasudevan
Journal of Robotic Surgery.2025;[Epub] CrossRef
Evaluating the Toumai MT‑1000 for urologic surgery: a systematic review and single-arm meta-analysis with remote and on-site experiences
Chi Zhang, Jinwan Wang
Journal of Robotic Surgery.2025;[Epub] CrossRef
A systematic review of comprehensive Robotic-assisted surgical (RAS) curricula
Anna K. Kieslich, Ruari Jardine, Hussain Ibrahim, Areeg Calvert, Kenneth G. Walker, Kim A. Walker, Angus J. M. Watson
Journal of Robotic Surgery.2025;[Epub] CrossRef
From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. CrossRef

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