CodiReal-PT: National Survey on Current Practices in Right Colon Oncological Surgery

Author:

Azevedo José Gonçalves Moreira de,Sousa Maria João Morais do Carmo Couto de1,Cunha Miguel Fernandes da Conceição2ORCID,Fernandez Laura Melina3,Rama Nuno José Gomes,Quintanilha Rui Paulo de Medeiros4

Affiliation:

1. Faculty of Medicine, University of Lisbon, Lisboa, Portugal

2. Portimão Colorectal Surgery Group, Surgery II Department, Algarve Local Health Unit, Portimão, Portugal

3. Colorectal Department, Digestive Unit, Champalimaud Foundation, Lisboa, Portugal

4. Surgery Department, Hospital do Divino Espírito Santo (HDES), Azores, Portugal

Abstract

Abstract Introduction Colorectal cancer (CRC) is the third most prevalent tumor. Right colon cancer (RCC) comprises one-third of CRC cases and is associated with poorer outcomes, emphasizing the need for optimized treatment strategies. The present study aims to explore the nuances in the management of RCC across Portugal, focusing on surgical approaches and multidisciplinary treatment. Materials and Methods The CodiReal-PT was a cross-sectional survey-based study adhering to the guidelines of the Checklist for Reporting Results of Internet E-Surveys (CHERRIES), focusing on current practices in RCC oncological surgery. The survey comprised 31 questions divided into 4 sections (demographics, multidisciplinary approach, surgery practices regarding RCC, and postoperative management). It was made available via e-mail to all active members of the Portuguese Society of Surgery (Sociedade Portuguesa de Cirurgia, SPCIR, in Portuguese), and data collection lasted from November to December 2022. Results Data from 69% of Portuguese public hospitals was obtained. All the participant hospitals had multidisciplinary team meetings to manage CRC cases. However, 17% (n = 6) did not discuss all elective-setting cases during their meetings. Dedicated colorectal surgical teams were present in 86% (n = 31) of hospitals. Furthermore, the presence of these dedicated teams was associated with better practices, namely a higher volume of right colectomies (mean: 51.8 ± 32.6 versus 23.8 ± 4.8; p = 0.001), a preference for the laparoscopic approach (93.5 versus 60.0%; p = 0.021), and standardization of anastomotic techniques (83.9 versus 40.0%; p = 0.029). Conclusion The present nationwide survey-based study provides a comprehensive landscape of RCC management practices across Portugal, underscoring the significant role of dedicated colorectal surgical teams and the need for further practice standardization. Nevertheless, multidisciplinary team meetings in all surveyed hospitals are an important indicator of improved RCC care. Future research should focus on the impact of specific surgical techniques on oncological outcomes and the potential benefits of centralizing care to high-volume centers.

Publisher

Georg Thieme Verlag KG

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