Rectal washout does not increase the complication risk after anterior resection for rectal cancer

World J Surg Oncol. 2021 Mar 19;19(1):82. doi: 10.1186/s12957-021-02193-7.

Abstract

Background: To reduce local recurrence risk, rectal washout (RW) is integrated in the total mesorectal excision (TME) technique when performing anterior resection (AR) for rectal cancer. Although RW is considered a safe practice, data on the complication risk are scarce. Our aim was to examine the association between RW and 30-day postoperative complications after AR for rectal cancer.

Methods: Patients from the Swedish Colorectal Cancer Registry who underwent AR between 2007 and 2013 were analysed using multivariable methods.

Results: A total of 4821 patients were included (4317 RW, 504 no RW). The RW group had lower rates of overall complications (1578/4317 (37%) vs. 208/504 (41%), p = 0.039), surgical complications (879/4317 (20%) vs. 140/504 (28%), p < 0.001) and 30-day mortality (50/4317 (1.2%) vs. 12/504 (2.4%), p = 0.020). In multivariable analysis, RW was a risk factor neither for overall complications (OR 0.73, 95% CI 0.60-0.90, p = 0.002) nor for surgical complications (OR 0.62, 95% CI 0.50-0.78, p < 0.001).

Conclusions: RW is a safe technique that does not increase the 30-day postoperative complication risk after AR with TME technique for rectal cancer.

Keywords: Cancer; Complications; Rectal; Resection; Washout.

MeSH terms

  • Humans
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / etiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prognosis
  • Rectal Neoplasms* / surgery
  • Treatment Outcome