Abstract
Background
Surgical technique might influence rectal cancer survival, yet international practices
for surgical treatment of rectal cancer are poorly described.
Methods
We performed a cross-sectional survey in a cohort of experienced colorectal surgeons
representing 123 centers.
Results
Seventy-one percent responded, 70% are from departments performing more than 50 proctectomies
annually. More than 50% defined the rectum as “15 cm from the verge.” Seventy-two
percent perform laparoscopic proctectomy, 80% use oral bowel preparation, 69% perform
high ligation of the inferior mesenteric artery, 76% divert stomas as routine for
colo-anal anastomosis, and 63% use enhanced recovery protocols. Different practices
exist between US and non-US surgeons: 15 cm from the verge to define the rectum (34%
vs 59%; P = .03), personally perform laparoscopic resection (82% vs 66%; P = .05), rectal stump washout (36% vs 73%; P = .0001), always drain after surgery (23% vs 42%; P = .03), transanal endoscopic microsurgery for T2N0 in medically unfit patients (39%
vs 61%; P = .0001).
Conclusions
Wide international variations in rectal cancer management make outcome comparisons
challenging, and consensus development should be encouraged.
Keywords
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Article info
Publication history
Received in revised form:
August 20,
2010
Received:
July 8,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
