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Colorectal cancer
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
Ann Coloproctol. 2023;39(4):307-314.   Published online October 11, 2022
DOI: https://doi.org/10.3393/ac.2022.00255.0036
  • 4,975 View
  • 124 Download
  • 6 Web of Science
  • 6 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Rectal cancer treatment has a wide range of possible approaches from radical extirpative surgery to nonoperative watchful waiting following chemoradiotherapy, with or without, additional chemotherapy. Our goal was to assess the personal opinion of active practicing surgeons on rectal cancer treatment if he/she was the patient.
Methods
A panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) selected 10 questions that were included in a questionnaire that included other items including demographics. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in our database and remained open from April 16 to 28, 2020.
Results
One hundred sixty-three specialists completed the survey. The majority of surgeons (n=65, 39.9%) chose the minimally invasive (laparoscopic) surgery for their personal treatment of rectal cancer. For low-lying rectal cancer T1 and T2, the treatment choice was standard chemoradiation+local excision (n=60, 36.8%) followed by local excision±chemoradiotherapy if needed (n=55, 33.7%). In regards to locally advanced low rectal cancer T3 or greater, the preference of the responders was for laparoscopic surgery (n=65, 39.9%). We found a statistically significant relationship between surgeons’ age and their preference for minimally invasive techniques demonstrating an age-based bias on senior surgeons’ inclination toward open approach.
Conclusion
Our survey reveals an age-based preference by surgeons for minimally invasive surgical techniques as well as organ-preserving techniques for personal treatment of treating rectal cancer. Only 1/4 of specialists do adhere to the international guidelines for treating early rectal cancer.

Citations

Citations to this article as recorded by  
  • Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
    Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
    Annals of Coloproctology.2024; 40(1): 13.     CrossRef
  • Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
    Chungyeop Lee, In Ja Park
    The World Journal of Men's Health.2024; 42(2): 304.     CrossRef
  • Effects of Adjuvant Chemotherapy on Oncologic Outcomes in Patients With Stage ⅡA Rectal Cancer Above the Peritoneal Reflection Who Did Not Undergo Preoperative Chemoradiotherapy
    Hyo Seon Ryu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Yong Sang Hong, Tae Won Kim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(4): 392.     CrossRef
  • Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
  • Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
    Annals of Surgical Treatment and Research.2023; 105(6): 341.     CrossRef
Mechanical Bowel Preparation and Prophylactic Antibiotic Administration in Colorectal Surgery: A Survey of the Current Status in Korea
Byung Mo Kang, Kil Yeon Lee, Sun Jin Park, Suk-Hwan Lee
Ann Coloproctol. 2013;29(4):160-166.   Published online August 29, 2013
DOI: https://doi.org/10.3393/ac.2013.29.4.160
  • 4,880 View
  • 48 Download
  • 19 Citations
AbstractAbstract PDF
Purpose

The usefulness of mechanical bowel preparation (MBP) in colon surgery was recently challenged by many multicenter clinical trials and meta-analyses. The objectives of this study were to investigate current national opinions about MBP and prophylactic antibiotics (PA) and to provide preliminary data for developing future Korean guidelines for MBP and PA administration in colorectal surgery.

Methods

A questionnaire was mailed to 129 colorectal specialists. The questionnaires addressed the characteristics of the hospital, the MBP methods, and the uses of oral and intravenous antibiotics.

Results

A total of 73 questionnaires (56.6%) were returned. First, in regard to MBP methods, most surgeons (97.3%) used MBP for a mean of 1.36 days. Most surgeons (98.6%) implemented whole bowel irrigation and used polyethylene glycol (83.3%). Oral antibiotic use was indicated in over half (52.1%) of the responses, the average number of preoperative doses was three, and the mean time of administration was 24.2 hours prior to the operation. Finally, the majority of responders stated that they used intravenous antibiotics (95.9%). The responses demonstrated that second-generation cephalosporin-based regimens were most commonly prescribed, and 75% of the surgeons administered these regimens until three days after the operation.

Conclusion

The results indicate that most surgeons used MBP and intravenous antibiotics and that half of them administered oral PA in colorectal surgery preparations. The study recommends that the current Korean guidelines should be adapted to adequately reflect the medical status in Korea, to consider the medical environment of the various hospitals, and to establish more accurate and relevant guidelines.

Citations

Citations to this article as recorded by  
  • RETRACTED: A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer
    Yani Chen, Hua Guo, Tian Gao, Jiale Yu, Yujia Wang, Haiquan Yu
    International Wound Journal.2024;[Epub]     CrossRef
  • Surgical Site Infections in Colorectal Cancer Surgeries: A Systematic Review and Meta-Analysis of the Impact of Surgical Approach and Associated Risk Factors
    Valentin Calu, Catalin Piriianu, Adrian Miron, Valentin Titus Grigorean
    Life.2024; 14(7): 850.     CrossRef
  • Uncovering the Function of MBP and Antibiotics in Preventing Surgical Site Infections during Colorectal Procedures
    Agnes Sara Shibu, Rojin G. Raj, Rohit Singh Deo
    Journal of Coloproctology.2024; 44(03): e209.     CrossRef
  • Single-Dose Versus Multiple-Dose Prophylactic Antibiotics in Minimally Invasive Colorectal Surgery: A Propensity Score Matched Analysis
    Ga Yoon Ku, Beom-jin Kim, Ji Won Park, Min Jung Kim, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Preoperative mechanical bowel preparation using conventional versus hyperosmolar polyethylene glycol-electrolyte lavage solution before laparoscopic resection for colorectal cancer (TLUMP test): a phase III, multicenter randomized controlled non-inferiori
    Tadashi Yoshida, Shigenori Homma, Nobuki Ichikawa, Yosuke Ohno, Yoichi Miyaoka, Hiroki Matsui, Ken Imaizumi, Hiroyuki Ishizu, Tohru Funakoshi, Masahiko Koike, Hirofumi Kon, Yo Kamiizumi, Yasuhiro Tani, Yoichi Minagawa Ito, Kazufumi Okada, Akinobu Taketomi
    Journal of Gastroenterology.2023; 58(9): 883.     CrossRef
  • The risk of surgical site infection of oral sulfate tablet versus sodium picosulfate for bowel preparation in colorectal cancer surgery: a randomized clinical trial
    Sung Sil Park, Sung Chan Park, Dong-Eun Lee, Dong Woon Lee, Kiho Yu, Hyoung-Chul Park, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh
    Annals of Surgical Treatment and Research.2022; 103(2): 96.     CrossRef
  • Preoperative Elemental Diet before Laparoscopic Anterior Resection in Patients with Advanced Stenotic Rectal Cancer
    Tadashi Yoshida, Shigenori Homma, Nobuki Ichikawa, Hiroaki Iijima, Akinobu Taketomi
    Journal of the Anus, Rectum and Colon.2021; 5(4): 395.     CrossRef
  • Orale Antibiotikaprophylaxe zur Darmdekontamination vor elektiver kolorektaler Chirurgie
    S. Flemming, C.-T. Germer
    Der Chirurg.2020; 91(2): 128.     CrossRef
  • Role of Mechanical Bowel Preparation for Elective Colorectal Surgery
    Ik Yong Kim
    The Korean Journal of Gastroenterology.2020; 75(2): 79.     CrossRef
  • Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis
    Zhaohui Xu, Hui Qu, George Kanani, Zhong Guo, Yanying Ren, Xin Chen
    International Journal of Colorectal Disease.2020; 35(12): 2147.     CrossRef
  • Does Mechanical Bowel Preparation Ameliorate Surgical Performance in Anterior Lumbar Interbody Fusion?
    Chang-Hoon Jeon, Han-Dong Lee, Nam-Su Chung
    Global Spine Journal.2019; 9(7): 692.     CrossRef
  • Mechanical Bowel Preparation Does Not Affect Clinical Severity of Anastomotic Leakage in Rectal Cancer Surgery
    Woong Bae Ji, Koo Yong Hahn, Jung Myun Kwak, Dong Woo Kang, Se Jin Baek, Jin Kim, Seon Hahn Kim
    World Journal of Surgery.2017; 41(5): 1366.     CrossRef
  • Comparing Mechanical Bowel Preparation With Both Oral and Systemic Antibiotics Versus Mechanical Bowel Preparation and Systemic Antibiotics Alone for the Prevention of Surgical Site Infection After Elective Colorectal Surgery
    Min Chen, Xue Song, Liang-zhou Chen, Zhi-dong Lin, Xue-li Zhang
    Diseases of the Colon & Rectum.2016; 59(1): 70.     CrossRef
  • Early Outcomes of Endoscopic Submucosal Dissection for Colorectal Neoplasms According to Clinical Indications
    Eui-Gon Youk, Dae Kyng Sohn, Chang Won Hong, Seong Dae Lee, Kyung Su Han, Byung Chang Kim, Hee Jin Chang, Mi-Jung Kim
    Diseases of the Colon & Rectum.2016; 59(5): 403.     CrossRef
  • Benefit of mechanical bowel preparation prior to elective colorectal surgery: current insights
    A. C. A. Murray, R. P. Kiran
    Langenbeck's Archives of Surgery.2016; 401(5): 573.     CrossRef
  • Is mechanical bowel preparation still necessary for gynecologic laparoscopic surgery? A meta‐analysis
    Huaping Huang, Haiyan Wang, Mei He
    Asian Journal of Endoscopic Surgery.2015; 8(2): 171.     CrossRef
  • Nationwide Analysis of Outcomes of Bowel Preparation in Colon Surgery
    Zhobin Moghadamyeghaneh, Mark H. Hanna, Joseph C. Carmichael, Steven D. Mills, Alessio Pigazzi, Ninh T. Nguyen, Michael J. Stamos
    Journal of the American College of Surgeons.2015; 220(5): 912.     CrossRef
  • Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery
    Youn Young Park, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Jung Joo Lee, Hye Ok Lee, Suk-Hwan Lee
    Annals of Coloproctology.2015; 31(6): 235.     CrossRef
  • Mechanical Bowel Preparation: Keep It or Abandon It?
    Hungdai Kim
    Annals of Coloproctology.2013; 29(4): 136.     CrossRef
International society of university colon and rectal surgeons survey of surgeons’ preference on rectal cancer treatment
Published online November 30, 1999  
  • 467 View
  • 0 Download
AbstractAbstract
tive watchful waiting following chemoradiotherapy, with or without, additional chemotherapy. Our goal was to assess the personal opinion of active practicing surgeons on rectal cancer treatment if he/she was the patient.
Methods
A panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) selected 10 questions that were included in a questionnaire that included other items including demographics. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in our database and remained open from April 16 to 28, 2020.
Results
One hundred sixty-three specialists completed the survey. The majority of surgeons (n=65, 39.9%) chose the minimally invasive (laparoscopic) surgery for their personal treatment of rectal cancer. For low-lying rectal cancer T1 and T2, the treatment choice was standard chemoradiation+local excision (n=60, 36.8%) followed by local excision±chemoradiotherapy if needed (n=55, 33.7%). In regards to locally advanced low rectal cancer T3 or greater, the preference of the responders was for laparoscopic surgery (n=65, 39.9%). We found a statistically significant relationship between surgeons’ age and their preference for minimally invasive techniques demonstrating an age-based bias on senior surgeons’ inclination toward open approach.
Conclusion
Our survey reveals an age-based preference by surgeons for minimally invasive surgical techniques as well as organ-preserving techniques for personal treatment of treating rectal cancer. Only 1/4 of specialists do adhere to the international guidelines for treating early rectal cancer.
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