Intraoperative rectal washout in rectal cancer surgery: a survey of current practice in the UK.

OBJECTIVES

Due to concerns about implantation of malignant cells during surgery for rectal cancer, traditionally, intraoperative rectal washout (IORW) has been performed to prevent local recurrence. But with the advent of laparoscopic surgery, many surgeons have abandoned this practice. The aim of this study was to assess current practice among colorectal surgeons in the UK.

METHODS

A 10-item questionnaire was sent by email to 452 consultant surgeons, who were members of the Association of Coloproctology of Great Britain & Ireland, and had previously agreed to participate in research projects.

RESULTS

The mean age of the 149 responders (n = 149, 33.0%) was 49.2 years. The mean number of years in independent practice was 12.1, and the mean number of rectal cancer cases performed per year was 20.3 and 20.6, in the years 2010 and 2011 respectively. 74.3% of the responders believed that there is an advantage in performing IORWs in rectal cancer resections. Of the 71.8% of all responders who performed laparoscopic rectal cancer resections, 54.8% routinely performed IORWs during laparoscopic resections. However, 87.2% of all responders performed IORWs in open resections for rectal cancer, and 79.2% had routinely performed IORWs before the advent of laparoscopic rectal cancer surgery.

CONCLUSIONS

Most colorectal surgeons believe that there is an advantage in performing IORWs. Although, most surgeons would routinely perform IORWs in open resections, they do not routinely perform these in laparoscopic resections.