Towards quality control in rectal cancer surgery: A preliminary Greek experience

Background: The purpose of this study was to evaluate the effect of the introduction of a colorectal unit on provided services for patients with rectal cancer. Methods: The colorectal unit in our department was initiated in January 2004. A dedicated database was used to retrieve data from 127 consecutive patients who were operated on electively from March 1995 to December 2005. Treatment parameters were compared for patients before (n = 90) and after (n = 37) the introduction of the colorectal unit. Results: In the entire group of patients, 50.3% presented with locally advanced disease (stage III) and 40.9% with tumours located in the lower third of the rectum. A higher preoperative versus postoperative radiotherapy ratio (P < 0.0001), a higher local excision rate (P = 0.04) and a higher low anterior resection to abdominoperineal resection ratio (P = 0.0011) were noted after the initiation of the colorectal unit. In this small series, although parameters like the number of examined lymph nodes, anastomotic leakage rate and distal resection margin improved, they did not reach statistical significance. Conclusions: The establishment of a colorectal unit seems to have resulted in improved quality of rectal cancer treatment by a dedicated multidisciplinary approach, even after only 2 years of service.