Rectal washout in rectal cancer surgery: A survey of Swedish practice – Questionnaire: Rectal washout in Swedish rectal cancer surgery

Introduction: To reduce local recurrence rates when performing anterior resection in rectal cancer surgery Swedish national guidelines recommend rectal washout. This study aimed to describe current Swedish practice of rectal washout. Methods: Questionnaires were sent to Swedish surgical departments performing rectal cancer surgery. Results: Thirty-five units performed open rectal cancer surgery, and 91% (32/35) performed minimally invasive surgery. Forty percent (14/35) had a protocol on rectal washout. Rectal washout was most commonly performed using sterile water or an alcohol based solution and with a minimum volume of 100–499 ml. A catheter was used at most units, prior to transection of the rectum and with the bowel clamped. Routine use of rectal washout varied with the type of surgical procedure, with no differences between open and minimally invasive surgery: low anterior resection (97% (34/35) vs 94% (30/32); p = 0.60), high anterior resection (94% (33/35) vs 97% (31/32); p = 1.00), Hartmann's procedure (80% (28/35) vs 84% (27/32); p = 0.75), abdominoperineal resection (6% (2/35) vs 16% (5/32); p = 0.25). Conclusion: Swedish colorectal units perform rectal washout routinely with no differences between open and minimally invasive procedures. A minority have a procedure protocol.