Precision and function preservation in gastrointestinal surgery: Integrating minimally invasive techniques, enhanced recovery, and metabolic interventions

Vollständiger Abstract

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Gastrointestinal surgery is shifting from pursuing radical oncology to emphasizing precision, functionalization, and rapid recovery. How to integrate laparoscopic and robotic surgery, enhanced recovery after surgery protocols, and metabolic regulatory mechanisms of bariatric surgery is a key issue in optimizing patient outcomes. This review focuses on three areas: (1) Short- and long-term outcomes of minimally invasive techniques for colorectal and gastric cancer, as well as surgical strategies for special populations; (2) Perioperative management innovation, including refined enhanced recovery after surgery practice and postoperative complication risk prediction models; and (3) The cross-integration of surgery and metabolic regulation, exploring gut microbiota remodeling, bile acid signaling, glucose metabolism, and surgical timing after conversion therapy. By synthesizing this evidence, this article provides a framework for advancing gastrointestinal surgery from “radical resection” to the “radical-functional-rehabilitation” trinity goal, and looks forward to intraoperative navigation and artificial intelligence-assisted decision-making in future individualized treatment.