Dulskas Audrius, Caushaj Philip F, Grigoravicius Domas, Zheng Liu, Fortunato Richard, Nunoo-Mensah Joseph W, Samalavicius Narimantas E
Department of Abdominal and General Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania.
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Ann Coloproctol. 2023 Aug;39(4):307-314. doi: 10.3393/ac.2022.00255.0036. Epub 2022 Oct 11.
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.
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.
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.
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.
直肠癌治疗有多种可能的方法，从根治性切除手术到放化疗后（有或没有额外化疗）的非手术观察等待。我们的目标是评估活跃的执业外科医生如果自己是患者时对直肠癌治疗的个人看法。
国际大学结肠和直肠外科医生学会（ISUCRS）的一个小组挑选了10个问题，这些问题包含在一份问卷中，问卷还包括其他项目，如人口统计学信息。问卷通过电子方式分发给ISUCRS会员以及我们数据库中的其他外科医生，问卷于2020年4月16日至28日开放填写。
163名专家完成了调查。大多数外科医生（n = 65，39.9%）选择微创（腹腔镜）手术作为他们个人直肠癌的治疗方式。对于低位直肠癌T1和T2，治疗选择是标准放化疗 + 局部切除（n = 60，36.8%），必要时随后进行局部切除±放化疗（n = 55，33.7%）。对于局部晚期低位直肠癌T3及以上，回答者的偏好是腹腔镜手术（n = 65，39.9%）。我们发现外科医生的年龄与他们对微创技术的偏好之间存在统计学上的显著关系，表明资深外科医生在倾向开放手术方式上存在基于年龄的偏差。
我们的调查揭示了外科医生在个人直肠癌治疗中基于年龄对微创外科技术以及保留器官技术的偏好。只有四分之一的专家确实遵循早期直肠癌治疗的国际指南。
