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Evolution of surgical approach to rectal cancer resection: A multinational registry assessment

2024; Springer Science+Business Media; Volume: 39; Issue: 1 Linguagem: Inglês

10.1007/s00384-023-04578-4

1432-1262

Julie Sijmons, Jan Willem T. Dekker, Jurriaan B. Tuynman, Helen Mohan, Philip Smart, Alexander G. Heriot, Kate Walker, Angela Kuryba, Peter Matthiessen, Pieter J. Tanis, Tarik Samour, Hidde M. Kroon, Sze‐Lin Peng, Neal Rawson, Shoni Philpot, Ian Hayes, Lene Hjerrild Iversen, Jon Kroll Bjerregaard, Camilla Qvortrup, Ismail Gögenür, Richard T. Spence, Rob A.�E.�M. Tollenaar, Roel Hompes, Federico Ghignone, Helen A. Blake, Nicola Fearnhead, Jan van der Meulen, Mike Braun, Arne Wibe, Janet Graham, Graham A. Mackay, David Morrison, Ingvar Syk, Clifford Y. Ko, Nicolás Avellaneda,

Colorectal and Anal Carcinomas

Surgical approach to rectal cancer has evolved in recent decades, with introduction of minimally invasive surgery (MIS) techniques and local excision. Since implementation might differ internationally, this study is aimed at evaluating trends in surgical approach to rectal cancer across different countries over the last 10 years and to gain insight into patient, tumour and treatment characteristics. Pseudo-anonymised data of patients undergoing resection for rectal cancer between 2010 and 2019 were extracted from clinical audits in the Netherlands (NL), Sweden (SE), England-Wales (EW) and Australia-New Zealand (AZ). Ninety-nine thousand five hundred ninety-seven patients were included (38,413 open, 55,155 MIS and 5416 local excision). An overall increase in MIS was observed from 29.9% in 2010 to 72.1% in 2019, with decreasing conversion rates (17.5–9.0%). The MIS proportion was highly variable between countries in the period 2010–2014 (54.4% NL, 45.3% EW, 39.8% AZ, 14.1% SE, P < 0.001), but variation reduced over time (2015–2019 78.8% NL, 66.3% EW, 64.3% AZ, 53.2% SE, P < 0.001). The proportion of local excision for the two periods was highly variable between countries: 4.7% and 11.8% in NL, 3.9% and 7.4% in EW, 4.7% and 4.6% in AZ, 6.0% and 2.9% in SE. Application and speed of implementation of MIS were highly variable between countries, but each registry demonstrated a significant increase over time. Local excision revealed inconsistent trends over time.