Technical Specifications for Super Minimally Invasive Stepwise Full-thickness Resection Surgery (sft-SMIR) for Colorectal Cancer

Abstract

This article outlines the technical specifications of super minimally invasive stepwise full-thickness resection surgery for colorectal cancer (sft-SMIR). sft-SMIR is a super minimally invasive surgery performed through natural orifices, combining endoscopic submucosal dissection (ESD) and full-thickness resection (EFTR) techniques, aimed at curing the disease while maximizing the preservation of the structure and function of the colorectal organs. The article specifies that this technique is suitable for early colon cancer, early rectal cancer, and locally advanced low rectal cancer after neoadjuvant therapy, detailing its indications and contraindications. It emphasizes the importance of multidisciplinary team (MDT) assessment, meticulous preoperative imaging and endoscopic evaluation, standardized intraoperative procedures (including marking, dissection, traction, full-thickness resection, and wound closure), as well as rigorous postoperative management and follow-up processes. Additionally, the expert consensus highlights the need for a strong focus on infection prevention and the establishment of standardized training and quality control systems to promote the safe and standardized application of this difficult endoscopic technique.