Population-Based Use of Sphincter-Preserving Surgery in Patients With Rectal Cancer

Abstract

These data suggest that the receipt of a permanent colostomy by many patients with rectal cancer may be inappropriate, and there is potential to increase the use of sphincter-preserving surgery in patients with rectal cancer.

Multi-institutional Assessment of Sphincter Preservation for Rectal Cancer

“…For example, previous research has suggested that female gender, lower stages and lower BMI, are associated with SPS. 4,5 In the present analysis, these associations are eliminated after adjusting for tumor location and the incorporation of a unique hospital identifier in the multivariable model. One can conclude that even among strictly defined eligibility criteria, some institutions have different practice patterns.…”

“…1 Modern techniques and stapling technology frequently permit sphincter preserving surgery (SPS) and the avoidance of a permanent stoma, even for low-lying tumors. 2–5 Accordingly, SPS-rates have been proposed as a quality measure for rectal cancer surgery and multiple reports have shown wide variations in its utilization. 6,7 …”

“…4,5 Moreover, previous studies using national registry data and hospital discharge data have shown that SPS rates vary based on patient demographics, education, geography and surgeon volume. 4,8–12 However, these data lack critical clinical details, such as tumor location or sphincter involvement, which are necessary to determine if patients are candidates for SPS.…”

Multi-institutional assessment of sphincter preservation for rectal cancer.

“…6,7 Population-based rates of SPS in Europe and Australia vary between 75-84% while rates in the US are anywhere between 48-77%. 4,5 Moreover, previous studies using national registry data and hospital discharge data have shown that SPS rates vary based on patient demographics, education, geography and surgeon volume. 4,[8][9][10][11][12] However, these data lack critical clinical details, such as tumor location or sphincter involvement, which are necessary to determine if patients are candidates for SPS.…”

“…1 Modern techniques and stapling technology frequently permit sphincter preserving surgery (SPS) and the avoidance of a permanent stoma, even for low-lying tumors. [2][3][4][5] Accordingly, SPSrates have been proposed as a quality measure for rectal cancer surgery and multiple reports have shown wide variations in its utilization. 6,7 Population-based rates of SPS in Europe and Australia vary between 75-84% while rates in the US are anywhere between 48-77%.…”