TY - JOUR
T1 - Evolution of surgical approach to rectal cancer resection
T2 - A multinational registry assessment
AU - Sijmons, Julie M. L.
AU - Dekker, Jan Willem T.
AU - Tuynman, Jurriaan B.
AU - Mohan, Helen M.
AU - Smart, Philip
AU - Heriot, Alexander G.
AU - Walker, Kate
AU - Kuryba, Angela
AU - Matthiessen, Peter
AU - Tanis, Pieter J.
N1 - Publisher Copyright: © 2024, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2024/12/1
Y1 - 2024/12/1
N2 - Purpose: 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. Methods: 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). Results: 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. Conclusions: 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.
AB - Purpose: 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. Methods: 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). Results: 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. Conclusions: 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.
KW - Audit
KW - Local excision
KW - Minimally invasive
KW - Open surgery
KW - Rectal cancer
KW - Registry
UR - http://www.scopus.com/inward/record.url?scp=85181472962&partnerID=8YFLogxK
U2 - 10.1007/s00384-023-04578-4
DO - 10.1007/s00384-023-04578-4
M3 - Article
C2 - 38183451
SN - 0179-1958
VL - 39
JO - International journal of colorectal disease
JF - International journal of colorectal disease
IS - 1
M1 - 15
ER -