{
  "abstract": "Background/objectives: To analyze risk factors for prolonged operative time (OT) in patients undergoing rectal cancer surgery, and to explore the effects of prolonged OT on immediate surgical outcomes and long-term oncological outcomes. Methods: A single-center retrospective review of all patients who underwent an elective rectal resection for primary rectal adenocarcinoma between 2010 and 2020. OT was standardized according to surgeon-specific and surgical approach-specific median values. Subsequently, the cohort was divided according to surgery duration: The Short OT group (244 patients; median OT 201 min, range 46–600) and the Long OT group (250 patients; median OT 340 min, range 145–960). Results: Multivariate analysis identified independent predictors for prolonged surgery: higher BMI (AOR 1.07, p = 0.002) and distance from anal verge (AOR 0.89, p < 0.001). Intraoperative complications occurred more frequently in the Long OT group (21.6% vs. 10.2%, p < 0.001), as did overall post-operative morbidity (73.2% vs. 60.7%, p = 0.003). The 5-year OS rates were comparable between groups (88.8% vs. 90.8%, p = 0.14); however, 5-year RFS was significantly worse in the Long OT group (65.5% vs. 78.2%, p = 0.004). Multivariable Cox regression using surgeon–approach standardized time quartiles showed reduced recurrence-free survival per one-quartile duration increase (HR 1.37, 95% CI 1.12–1.69, p = 0.002). Conclusions: Higher BMI and lower tumor location were found to be independent preoperative predictors of prolonged rectal cancer surgery. Prolonged operative time was associated with higher perioperative morbidity and poorer long-term recurrence-free survival.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Surgery, The Chaim Sheba Medical Center, Ramat Gan 52621, Israel",
    "Gray Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Dan Assaf"
    },
    {
      "affs": [
        0
      ],
      "name": "Nadav Elbaz"
    },
    {
      "affs": [
        1
      ],
      "name": "Yasmin Anderson"
    },
    {
      "affs": [
        1
      ],
      "name": "Ofir Gruper"
    },
    {
      "affs": [
        1
      ],
      "name": "Lior Bear"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Eyal Mor",
      "orcid": "0000-0002-3235-2946"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Niv Pencovich"
    },
    {
      "affs": [
        0
      ],
      "name": "Gali Westrich",
      "orcid": "0000-0002-6332-8869"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Lior Segev",
      "orcid": "0000-0001-7972-9424"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1yjsjbtv9ekac.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218473",
  "fulltext_url": null,
  "id": "1yjsjbtv9ekac",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8473",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/1yjsjbtv9ekac.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:21:07Z",
      "native_id": "10.3390/jcm15218473",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8473"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Predictors and Prognostic Implications of Prolonged Operative Time in Rectal Cancer Surgery: An Analysis Adjusted for Surgeon and Surgical Approach",
  "title_text": "Predictors and Prognostic Implications of Prolonged Operative Time in Rectal Cancer Surgery: An Analysis Adjusted for Surgeon and Surgical Approach",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T00:21:04Z",
  "url": "https://research.draconitic.com/paper/1yjsjbtv9ekac",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}