Introduction: In the context of colorectal cancer treatment, the impact of surgical approaches on the systemic inflammatory response is of critical importance for postoperative outcomes and oncological prognosis. The systemic immune-inflammation index (SII) is a notable example of a robust and comprehensive biomarker with prognostic value. Defining a comparison between the effects of minimally invasive and open surgical methods on postoperative SII values in patients with rectal cancer. Methods: The present study was conducted by retrospectively examining data from 501 patients who underwent surgical treatment for rectal cancer at a tertiary center. Patients were divided into three groups, namely robotic, laparoscopic, and open surgery. Postoperative inflammatory markers (SII, neutrophil–lymphocyte ratio, and platelet–lymphocyte ratio) were then compared. Results: Our results revealed that patients who underwent open surgery exhibited significantly elevated postoperative SII values ( P = .004). In the context of minimally invasive approaches, the robotic surgery group demonstrated a reduction in postoperative SII values, with a statistical significance of P < .001. Conclusion: This study is the first series to biochemically demonstrate that minimally invasive approaches in rectal cancer surgery significantly reduce postoperative systemic inflammatory response (SII) compared with open surgery. The lowest SII values observed, particularly in robotic surgery, support the idea that this method causes less tissue trauma and better protects the immune system. SII supports the clinical superiority of minimally invasive surgery as a practical, objective, and highly prognostic biomarker for assessing the effects of postoperative inflammation and surgical trauma.
Simsek et al. (Sun,) studied this question.