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CC BY 4.0 · Journal of Coloproctology 2024; 44(03): e171-e179
DOI: 10.1055/s-0044-1788912
Original Article

CodiReal-PT: National Survey on Current Practices in Right Colon Oncological Surgery[*]

José Gonçalves Moreira de Azevedo   *
1   Colorectal Department, Digestive Unit, Champalimaud Foundation, Lisboa, Portugal
2   Faculty of Medicine, University of Lisbon, Lisboa, Portugal
,
Maria João Morais do Carmo Couto de Sousa   *
2   Faculty of Medicine, University of Lisbon, Lisboa, Portugal
,
Miguel Fernandes da Conceição Cunha    *
3   Portimão Colorectal Surgery Group, Surgery II Department, Algarve Local Health Unit, Portimão, Portugal
,
Laura Melina Fernandez
1   Colorectal Department, Digestive Unit, Champalimaud Foundation, Lisboa, Portugal
,
Nuno José Gomes Rama
4   Colorectal Surgical Division, Leiria Local Health Unit, Leiria, Portugal
5   Abel Salazar Biomedical Institute (ICBAS), University of Oporto, Porto, Portugal
6   Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
,
Rui Paulo de Medeiros Quintanilha
7   Surgery Department, Hospital do Divino Espírito Santo (HDES), Azores, Portugal
› Author Affiliations Funding The authors declare that they have not received funding from agencies in the public, private or non-profit sectors to conduct the present study.
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Abstract

Introduction Colorectal cancer (CRC) is the third most prevalent tumor. Right colon cancer (RCC) comprises one-third of CRC cases and is associated with poorer outcomes, emphasizing the need for optimized treatment strategies. The present study aims to explore the nuances in the management of RCC across Portugal, focusing on surgical approaches and multidisciplinary treatment.

Materials and Methods The CodiReal-PT was a cross-sectional survey-based study adhering to the guidelines of the Checklist for Reporting Results of Internet E-Surveys (CHERRIES), focusing on current practices in RCC oncological surgery. The survey comprised 31 questions divided into 4 sections (demographics, multidisciplinary approach, surgery practices regarding RCC, and postoperative management). It was made available via e-mail to all active members of the Portuguese Society of Surgery (Sociedade Portuguesa de Cirurgia, SPCIR, in Portuguese), and data collection lasted from November to December 2022.

Results Data from 69% of Portuguese public hospitals was obtained. All the participant hospitals had multidisciplinary team meetings to manage CRC cases. However, 17% (n = 6) did not discuss all elective-setting cases during their meetings. Dedicated colorectal surgical teams were present in 86% (n = 31) of hospitals. Furthermore, the presence of these dedicated teams was associated with better practices, namely a higher volume of right colectomies (mean: 51.8 ± 32.6 versus 23.8 ± 4.8; p = 0.001), a preference for the laparoscopic approach (93.5 versus 60.0%; p = 0.021), and standardization of anastomotic techniques (83.9 versus 40.0%; p = 0.029).

Conclusion The present nationwide survey-based study provides a comprehensive landscape of RCC management practices across Portugal, underscoring the significant role of dedicated colorectal surgical teams and the need for further practice standardization. Nevertheless, multidisciplinary team meetings in all surveyed hospitals are an important indicator of improved RCC care. Future research should focus on the impact of specific surgical techniques on oncological outcomes and the potential benefits of centralizing care to high-volume centers.

Keywords

Right Colon Cancer - oncologic Surgery - surgery - Portugal

Authors' Contributions

All authors contributed to the study's conception and design. J.G.M.A., M.J.M.C.C.S., and M.F.C.C. are joint first authors, having prepared the materials, collected data, and analyzed them. J.G.M.A. wrote the first draft of the manuscript, and all authors commented on previous versions. All authors read and approved the final manuscript. The Supplementary Material cites all the CodiReal collaborators and responders.


Data Availability

The authors confirm that the data supporting this study's findings are available in the article and its supplementary materials. Additional data supporting the findings are available from the corresponding author upon reasonable request.


Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. The study did not require Institutional Review Board approval as it did not involve collecting patient clinical data.


Informed Consent

Informed consent was obtained from all participants before survey completion, per the CHERRIES guidelines adherence requirement.


* Representing the CodiReal Collaborative, all authors had a hand in conceptualizing and designing the study. José Gonçalves Moreira de Azevedo, Maria João Morais do Carmo Couto de Sousa, and Miguel Fernandes da Conceição Cunha received first authorship recognition for their work in preparing materials, gathering, and analyzing data. José Gonçalves Moreira de Azevedo penned the initial manuscript draft, with all authors contributing revisions to prior versions.


Supplementary Material



Publication History

Received: 05 May 2024

Accepted: 05 June 2024

Article published online:
19 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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