Review for 10.1186/s12876-025-03872-5 (2025)

Title: Risk factors for unplanned 31-day readmission after surgery for colorectal cancer Patients:
a meta-analysis
Version: 1 Date: 12 Feb 2025
Reviewer:  Fan He
Reviewer's report:
It is my great honor to have the opportunity to review this manuscript titled "Effect of
Neoadjuvant Therapy on Textbook Outcomes in Minimally Invasive Rectal Cancer Surgery".
Through a retrospective analysis, the authors explored the impact of neoadjuvant therapy for
rectal cancer on the textbook clinical outcomes after minimally invasive surgery and its related
factors, reminding us to pay more attention to the perioperative period of radical surgery
for rectal cancer patients receiving neoadjuvant therapy. Regarding the completeness of the
manuscript, I put forward the following suggestions:
1. The English language editing of the manuscript is rather poor. It is recommended to include
a native English - speaking co-author to edit the language of the manuscript.
2. It is suggested to add the OR values, P values, etc. of the research results to the results section
of the abstract.
3. The writing logic of the first three paragraphs of the research background is rather confusing.
For example, in the first paragraph, the author mentioned that we should not only focus on the
impact of complications and mortality, but in the third paragraph, it is stated that the assessment
of complications is crucial. In addition, the introduction of the greater cost - effectiveness of
TME surgery alone compared to TME surgery combined with NT is not helpful for this study.
It is recommended that the author reorganize the language of this part.
4. It is recommended that the author add several sub - headings in the methods section to make
the manuscript framework more reasonable.
5. In the first point of the inclusion criteria, the author mentioned colorectal adenocarcinoma,
which should be rectal adenocarcinoma. In addition, the third point of the exclusion criteria
duplicates the second point of the inclusion criteria.
6. The author mentioned in the methods section that patients with metastatic colorectal cancer
indicated by preoperative examinations were excluded, but Table 1 shows 34 stage IV rectal
cancer patients.
7. Is it necessary to describe the neoadjuvant treatment regimen in such detail in the methods
section? This is not the focus of this study.
8. What is the basis for the author to perform multivariate analysis on the factors with P < 0.02
in the univariate analysis results?
9. Neoadjuvant radiotherapy and neoadjuvant chemotherapy have quite different impacts
on the peri - operative period of rectal cancer. Can the author list the proportions of
patients who received only neoadjuvant chemotherapy and those who received neoadjuvant
chemoradiotherapy among the patients included in this study? If subgroup analysis can be
performed when the sample size is sufficient, the research results will be more persuasive.
10. Table 1 contains a lot of content. It is recommended that the author split Table 1 into two
tables, one for patient demographic indicators and the other for peri - operative clinical data.
11. It is recommended to explain in the methods section whether the patients who underwent
robotic surgery had total laparoscopic reconstruction of the digestive tract.
12. The presentation of Table 2 is not helpful. It can be described in words in the conclusion
section of the manuscript.
13. Table 3 shows the results of univariate and multivariate regression analyses of the influencing
factors of TO. It is recommended to improve the title.
14. It is recommended to beautify the flow chart in Figure 1.
15. Figure 3 can be presented in a table.