Title: Risk Factors for Organ-Space Surgical Site Infections After Minimally Invasive Rectal
Cancer Surgery: A Retrospective Cohort Study
Version: 4 Date: 21 Oct 2024
Reviewer's report:
Dear authors:
Thank you for the opportunity to review your interesting manuscript.
Most of your findings confirm findings of other groups and add valuable evidence in this field.
I wonder whether the higher incidence of  surgical site infection in the intersphincteric resection
group is related to the more difficult and prolonged dissection in these patients. Can you
comment on this please.
The same is true for the group 'hand-sewn anastomosis'.  As you state this was necessary in
patients where a linear stapler could not be used - certainly this has resulted in longer and
technically more challenging operations.  This would have contributed to a higher risk of SSI
as well.
It would be helpful to analyse the differences of the length of surgery with regard to  the effect
on SSI.  The increased  SSI rate in robotic surgery could also be related to the longer operating
times in these patients.
Please consider these comments for your resubmission.
Kind regards, Matthias Wichmann (FRACS)
Title: Risk Factors for Organ-Space Surgical Site Infections After Minimally Invasive Rectal
Cancer Surgery: A Retrospective Cohort Study
Version: 4 Date: 21 Oct 2024
Reviewer's report:
Dear authors:
Thank you for the opportunity to review your interesting manuscript.
Most of your findings confirm findings of other groups and add valuable evidence in this field.
I wonder whether the higher incidence of  surgical site infection in the intersphincteric resection
group is related to the more difficult and prolonged dissection in these patients. Can you
comment on this please.
The same is true for the group 'hand-sewn anastomosis'.  As you state this was necessary in
patients where a linear stapler could not be used - certainly this has resulted in longer and
technically more challenging operations.  This would have contributed to a higher risk of SSI
as well.
It would be helpful to analyse the differences of the length of surgery with regard to  the effect
on SSI.  The increased  SSI rate in robotic surgery could also be related to the longer operating
times in these patients.
Please consider these comments for your resubmission.
Kind regards, Matthias Wichmann (FRACS)
Please review this paper.
user
Title: Risk Factors for Organ-Space Surgical Site Infections After Minimally Invasive Rectal
Cancer Surgery: A Retrospective Cohort Study
Version: 4 Date: 21 Oct 2024
Reviewer's report:
Dear authors:
Thank you for the opportunity to review your interesting manuscript.
Most of your findings confirm findings of other groups and add valuable evidence in this field.
I wonder whether the higher incidence of  surgical site infection in the intersphincteric resection
group is related to the more difficult and prolonged dissection in these patients. Can you
comment on this please.
The same is true for the group 'hand-sewn anastomosis'.  As you state this was necessary in
patients where a linear stapler could not be used - certainly this has resulted in longer and
technically more challenging operations.  This would have contributed to a higher risk of SSI
as well.
It would be helpful to analyse the differences of the length of surgery with regard to  the effect
on SSI.  The increased  SSI rate in robotic surgery could also be related to the longer operating
times in these patients.
Please consider these comments for your resubmission.
Kind regards, Matthias Wichmann (FRACS)
assistant