[Interpretation of technical operation standards for modified Bacon procedure (2026 edition)]

Technical Operation Standards for Modified Bacon Surgery (2026 Edition) (hereinafter referred to as the Standards) aims to systematically standardize the operative techniques of this procedure and promote its standardized implementation. The Standards are based on "one core principle, two techniques, three classifications, four necrosis types, and five nursing measures". This framework establishes specific technical operation standards for key aspects including indication and contraindication management, fixation and resection of the exteriorized bowel segment, tumor transection methods, classification and management of exteriorized bowel necrosis, and perioperative nursing measures. This article focuses on interpreting the five key features of the standards: (1) strict adherence to surgical indications and contraindications; (2) detailing single-stitch and multi-stitch fixation techniques for two-stage resection; (3) proposing for the first time three-type classification for tumor transection to guide preoperative decision-making; (4) introducing a four-type classification for necrosis of the exteriorized bowel segment, shifting management of this complication from empirical judgment to a classification-guided approach; and (5) systematically recommending five nursing measures-positional care, skin protection, postoperative analgesia, home care, and prevention of anastomotic stricture combined with pelvic floor muscle training-to create a comprehensive continum of postoperative care. This article also addresses the limitations of the Standards regarding technical standards for complex issues and levels of evidence, and interprets them in light of future research directions. It aims to provide a reference for the standardized implementation of modified Bacon surgery.