Dr. Hassan R. Hashmi

Prehabilitation is becoming an increasingly important part of surgical care.

A major new study published in JAMA Surgery demonstrated that a standardized multimodal prehabilitation program before colorectal cancer surgery was associated with:

-Reduced postoperative complications
-Fewer ICU admissions
-Shorter hospital stays

Importantly, benefits were seen across age groups and ASA classes, highlighting that improving functional reserve before surgery may meaningfully influence postoperative recovery and outcomes.

The program included:

-Supervised exercise training
-Nutritional optimization
-Psychological support
-Smoking cessation
-Frailty and anemia management

As colorectal surgery continues evolving toward enhanced recovery and evidence-based perioperative care, studies like this highlight the value of optimizing patients before surgery to improve recovery and outcomes.

Prehabilitation may represent one of the most impactful opportunities to improve surgical outcomes before a patient enters the operating room.

**alCancer

The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Surgeons American Cancer Society Cancer Action Network - ACS CAN Spring Valley Hospital Medical Center Summerlin Hospital Medical Center Dignity Health - St. Rose Dominican Hospital, Siena Campus - Henderson, NV

Reviewed this practical 2024 Cochrane Review today comparing purse-string versus linear skin closure after stoma reversal.

The pooled analysis suggested surgical site infection (SSI) rates decreased from roughly 24% with conventional linear closure to approximately 5% with purse-string closure.

SSI after ileostomy/colostomy reversal remains one of the most common postoperative issues colorectal surgeons encounter, making this a clinically relevant topic worth revisiting.

Interesting evidence showing how relatively small technical decisions in surgery can potentially have a meaningful impact on patient outcomes.



Article link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014763.pub2/full

The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Surgeons

Today, on National Nurses Day, I want to recognize and thank the incredible nurses who are the backbone of healthcare.

Behind every successful operation, recovery, ICU stay, clinic visit, and patient outcome is a team of nurses whose skill, vigilance, compassion, and resilience make an immeasurable difference every single day.

As surgeons, we quickly learn that outstanding patient care is never achieved alone. It is built through teamwork, trust, communication, and the unwavering dedication of nurses who advocate for patients at their most vulnerable moments.

Thank you for the countless unseen things you do every day, including the long hours, the critical thinking, the calm during emergencies, the compassion during difficult moments, and the strength you bring to healthcare.

Happy National Nurses Day and Nurses Week 2026!



Photo credits: American Nurses Association

National Nurses United OncoDaily Centennial Hills Hospital Medical Center Valley Hospital Las Vegas Desert View Hospital Dignity Health - St. Rose Dominican Hospital, Siena Campus - Henderson, NV Spring Valley Hospital Medical Center Summerlin Hospital Medical Center Southern Nevada Health District

A timely review from JAMA highlights a critical reality: obesity is not just a metabolic condition, it is a major oncologic risk factor.

With approximately 10% of new cancer diagnoses annually in the U.S. linked to obesity, and even higher proportions in cancers such as endometrial and hepatobiliary, this calls for a broader focus on prevention.

What stands out is the biology. Chronic inflammation, hormonal dysregulation, immune suppression, and microbiome alterations all converge to promote tumorigenesis.

This is particularly relevant in colorectal cancer too, where rising obesity rates parallel increasing incidence, including in younger patients.

Encouragingly, sustained weight loss of more than 10% may help reduce cancer risk.

As surgeons and clinicians, this reinforces that cancer prevention starts long before the endoscopy suite.



American College of Surgeons American Cancer Society Cancer Action Network - ACS CAN OncoDaily The American Society of Colon and Re**al Surgeons - ASCRS American Society of Clinical Oncology American College of Gastroenterology Colorectal Cancer Alliance

On Earth Day 2026, a moment to reflect!

Standing in Grand Teton National Park last fall, I was reminded how interconnected everything truly is.

The health of our environment directly shapes the health of our communities. Clean air, clean water, and preserved ecosystems are the foundation of human well-being.

It’s worth reflecting on how each of us can contribute in small but meaningful ways to protecting what sustains us.



The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Surgeons World Health Organization (WHO) Grand Teton National Park National Park Service

Honored to be appointed to the International Committee at the American Society of Colon and Re**al Surgeons (ASCRS).

Thankful to Dr. Kirsten Wilkins for the opportunity to serve. I look forward to working with Dr. Leandro Feo and colleagues to support international engagement and advance colorectal surgery in underserved regions.



The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Gastroenterology

Early detection of anastomotic leak saves lives.

A recent study published in JAMA Surgery highlights a critical reality in colorectal surgery. Delayed diagnosis of anastomotic leak significantly increases failure to rescue (FTR), meaning mortality after a complication.

The key message is clear. It is not just the complication, but also the timing of recognition that determines outcomes.

Patients with delayed diagnosis, especially after the onset of sepsis, had:

-Higher complication burden
-Increased reoperation rates
-Longer hospital stays
-Significantly higher mortality

As surgeons, this reinforces a fundamental responsibility. Vigilance in the postoperative period, early suspicion, and decisive intervention truly impact survival.

Improving systems for early detection of anastomotic leak and escalation of care are powerful quality improvement strategies which could improve mortality associated with colon resection.



The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily American College of Surgeons American College of Gastroenterology

A major step forward in biomarker-driven adjuvant therapy for colon cancer.

In the phase 3 ATOMIC trial published in nejm the addition of atezolizumab to mFOLFOX6 significantly improved 3-year disease-free survival in resected stage III dMMR colon cancer (86.3% vs 76.2%; HR 0.50).

This is one of the strongest signals yet supporting immunotherapy in the adjuvant setting for dMMR disease, a population already known to have distinct tumor biology and immune responsiveness.

The tradeoff is a higher rate of grade 3–4 toxicities, highlighting the importance of careful patient selection and counseling.

Key implications:

Reinforces the importance of MMR testing

Opens the door for integrating immunotherapy in the treatment paradigm

Raises important questions about optimal duration, cost, and long-term survival benefit

Practice-changing data worth watching closely.



American College of Surgeons The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily fightcrc Colorectal Cancer Alliance American Society of Clinical Oncology

A strong signal from high-level evidence in colorectal surgery.

A recent meta-analysis of randomized trials (n=4754) published in The Lancet Gastroenterology & Hepatology demonstrates that indocyanine green fluorescence angiography (ICGFA) significantly reduces anastomotic leak rates (RR 0.66, NNT 24).

The benefit is particularly compelling in:

• Left-sided resections
• Re**al resections
• Low anterior resections (NNT as low as 13)

Notably, the protective effect increases with higher BMI, suggesting a meaningful role for selective use in higher-risk patients. No significant benefit was observed in right-sided resections.

Trial sequential analysis indicates that sufficient evidence has likely been reached. The question is no longer “does it work?” but:

How do we implement it effectively?
Which patients would benefit the most?

As we continue refining anastomotic safety, this reinforces a broader principle of objective perfusion assessment.

Are you using ICGFA routinely, or selectively?



The American Society of Colon and Re**al Surgeons - ASCRS amcollsurgeons

Today is Lynch Syndrome Awareness Day.

Lynch syndrome is the most common hereditary colorectal cancer syndrome, yet it remains underdiagnosed.

Up to 1 in 300 individuals may carry a mismatch repair gene mutation, but many are identified only after developing cancer.

As surgeons and clinicians, this has real implications:

• Early-onset colorectal cancer
• Synchronous/metachronous malignancies
• Risk beyond the colon: endometrial, ovarian, gastric

Universal tumor testing for the mismatch repair deficiency is no longer optional. It’s essential.

Identifying Lynch syndrome doesn’t just change one patient’s care; it impacts an entire family.

Are we doing enough to recognize it early?



The American Society of Colon and Re**al Surgeons - ASCRS OncoDaily Las Vegas Review-Journal Colorectal Cancer Alliance Colon Cancer Coalition American Cancer Society American College of Surgeons Colon Cancer Alliance for Research & Education for Lynch Syndrome - CCARE

Image courtesy: Lynsight