Self-evaluation of a clinical pathway to improve the results of rectal cancer

Evaluation of quality parameters of rectal cancer surgery at the Coloproctology Unit of Hospital de Braga

“…The most common surgery in the coloproctology functional unit was the low anterior rectal resection (30.2%), which is in accordance with rates found in literature, of 39.5% 38 and 47.3% 23 . As to the parameter "sphincter sparing surgery", in Sweden and Spain the recommended values are higher than 70% 24,39 of the performed surgery; in Norway and the Netherlands, the ideal value is between 65 and 70% 28,40 .…”

“…As to the location of the RC, our studied showed that 53% of the cases were in the medium rectum, which is similar to findings from studies conducted in Germany, Spain and the United States of America, in which 40 to 55% of the cancers had this anatomical location 22,25,38 . The administration of primary therapy is currently essential to approach locally advanced RC or with ganglion invasion, since it increases the possibility of resection, decreases the locoregional recurrence rate and increases survival rates 23 .…”

“…In order to study the number of analyzed ganglia, the cohort value was established based on criteria of different surgeon associations, which recommend the analysis of at least 12 negative ganglia 41,46,47 . This way, it is possible to confirm with 90% accuracy that the patient is free of lymphatic invasion 38,48 . In one of the studies conduct- ed in Germany, it was defined that more than 75% of the surgeries should have more than 12 analyzed ganglia; in Spain, the value presented for such indicator is around 71% 22,38 .…”

“…This way, it is possible to confirm with 90% accuracy that the patient is free of lymphatic invasion 38,48 . In one of the studies conduct- ed in Germany, it was defined that more than 75% of the surgeries should have more than 12 analyzed ganglia; in Spain, the value presented for such indicator is around 71% 22,38 . In this context, the percentage of cases in which 12 or more ganglia were analyzed (36.6%) is lower than the minimum required value.…”