Standardization of rectal cancer surgery and bowel preparation in Austria : A multicenter nationwide survey by the Austrian Society of Surgical Oncology

Background: Standardized management of colorectal cancer is crucial for achieving an optimal clinical and oncological outcome. The present nationwide survey was designed to provide data about the surgical management of rectal cancer patients. In addition, we evaluated the standard approach for bowel preparation in all centers in Austria performing elective colorectal surgery.

Methods: The Austrian Society of Surgical Oncology (ACO["Arbeitsgemeinschaft für chirurgische Onkonlogie"]-ASSO) conducted a multicenter questionnaire-based study comprising 64 hospitals between October 2020 and March 2021.

Results: The median number of low anterior resections performed annually per department was 20 (range 0-73). The highest number was found in Vienna, with a median of 27 operations, whereas Vorarlberg was the state with the lowest median number of 13 resections per year. The laparoscopic approach was the standard technique in 46 (72%) departments, followed by the open approach in 30 (47%), transanal total mesorectal excision (TaTME) in 10 (16%) and robotic surgery in 6 hospitals (9%). Out of 64 hospitals 51 (80%) named a standard for bowel preparation before colorectal resections. No preparation was commonly used for the right colon (33%).

Conclusion: Considering the low number of low anterior resections performed in each hospital per year in Austria, defined centers for rectal cancer surgery are still scarce. Many hospitals did not transfer recommended bowel preparation guidelines into clinical practice.