Rectal washout during abdominoperineal resection for rectal cancer has no impact on the oncological outcome.

Abstract

Intraoperative rectal washout is performed to eliminate exfoliated intraluminal cancer cells and thereby decrease the risk of local recurrence. Rectal washout in abdominoperineal resection has not been studied. The aim of this study was to assess the oncological outcome after rectal washout in abdominoperineal resection for rectal cancer and to find evidence as to whether rectal washout should be performed or not. Data for all patients registered in the Swedish Colorectal Cancer Registry who underwent elective surgery with abdominoperineal resection for rectal cancer (TNM Stages I-III) between 2007 and 2013 were analysed using multivariable analysis. No significant differences were shown between the rectal washout group and the no rectal washout group for local recurrence [10/265 (3.8%) vs. 87/2160 (4.0%), p=0.84], distant metastasis [51/265 (19.2%) vs. 476/2160 (22.0%), p=0.29] or overall recurrence [53/265 (20.0%) vs. 505/2160 (23.4%), p=0.21]. In multivariable analysis, rectal washout did not significantly affect the oncological outcome in terms of local recurrence, distant metastasis, overall recurrence or 5-year overall or relative survival. Our results do not support routine rectal washout during abdominoperineal resection in order to improve the oncological outcome.