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

Azevedo, José Gonçalves Moreira de; Sousa, Maria João Morais do Carmo Couto de; Cunha, Miguel Fernandes da Conceição; Fernandez, Laura Melina; Rama, Nuno José Gomes; Quintanilha, Rui Paulo de Medeiros

doi:10.1055/s-0044-1788912

José Gonçalves Moreira de Azevedo

joint first authors

having prepared the materials

collected data

analyzed them

contributed to the study's conception and design

commented on previous versions

read and approved the final manuscript

The Supplementary Material cites all the CodiReal collaborators and responders

wrote the first draft of the manuscript

Colorectal Department, Digestive Unit, Champalimaud Foundation, Lisboa, Portugal

Faculty of Medicine, University of Lisbon, Lisboa, Portugal

* 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.

Maria João Morais do Carmo Couto de Sousa

joint first authors

having prepared the materials

collected data

analyzed them

contributed to the study's conception and design

commented on previous versions

read and approved the final manuscript

The Supplementary Material cites all the CodiReal collaborators and responders

Faculty of Medicine, University of Lisbon, Lisboa, Portugal

* 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.

Miguel Fernandes da Conceição Cunha Address for correspondence Miguel Fernandes da Conceição Cunha, Portimão Colorectal Surgery Group, Surgery II Department, Algarve Local Health Unit, Sitio do Poço Seco 8.500, Portimão, Portugal (email: Miguelcunha86@gmail.com).

joint first authors

having prepared the materials

collected data

analyzed them

contributed to the study's conception and design

commented on previous versions

read and approved the final manuscript

The Supplementary Material cites all the CodiReal collaborators and responders

Portimão Colorectal Surgery Group, Surgery II Department, Algarve Local Health Unit, Portimão, Portugal

* 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.

https://orcid.org/0000-0002-7353-2425

Laura Melina Fernandez

contributed to the study's conception and design

commented on previous versions

read and approved the final manuscript

The Supplementary Material cites all the CodiReal collaborators and responders

Colorectal Department, Digestive Unit, Champalimaud Foundation, Lisboa, Portugal

Nuno José Gomes Rama

contributed to the study's conception and design

commented on previous versions

read and approved the final manuscript

The Supplementary Material cites all the CodiReal collaborators and responders

Colorectal Surgical Division, Leiria Local Health Unit, Leiria, Portugal

Abel Salazar Biomedical Institute (ICBAS), University of Oporto, Porto, Portugal

Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal

Rui Paulo de Medeiros Quintanilha

contributed to the study's conception and design

commented on previous versions

read and approved the final manuscript

The Supplementary Material cites all the CodiReal collaborators and responders

Surgery Department, Hospital do Divino Espírito Santo (HDES), Azores, Portugal

Address for correspondence
Miguel Fernandes da Conceição Cunha, Portimão Colorectal Surgery Group, Surgery II Department, Algarve Local Health Unit, Sitio do Poço Seco 8.500, Portimão, Portugal (email: Miguelcunha86@gmail.com).

Conflict of Interests

The authors have no conflict of interests to declare.

*
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.

		Hospital volume			Colorectal surgeon volume (surgeries)
		< 100 colorectal surgeries per year (n = 16)	> 100 colorectal surgeries per year (n = 19)	^* * Descriptive statistics were expressed as mean and standard deviation valuess, while categorical data were expressed as proportions. The associations among the variables were studied using the independent-sample Mann-Whitney U-test for continuous variables and Chi-squared tests for categorical data. p-value	< 10 (n = 10)	≥ 10 (n = 19)	^* * Descriptive statistics were expressed as mean and standard deviation valuess, while categorical data were expressed as proportions. The associations among the variables were studied using the independent-sample Mann-Whitney U-test for continuous variables and Chi-squared tests for categorical data. p-value
Number of colorectal surgeries (mean)		62.19 ± 23.8	216.32 ± 88.4	0.001	^ Not applicable. NA	^ Not applicable. NA
Open approach: n (%)				0.367			0.206
	0–20%	5 (31.3)	8 (42.1)		1 (10.0)	8 (42.1)
	21–40%	4 (25.0)	8 (42.1)		5 (50.0)	6 (31.6)
	41–60%	5 (31.3)	3 (15.8)		4 (40.0)	5 (26.3)
	61–80%	1 (6.3)	−		−	−
	81–100%	1(6.3)	−		−	−
	Do not know	−	−		−	−
Laparoscopic approach: n (%)				0.380			0.860
	0–20%	2 (12.5)			−	−
	21–40%	1 (6.3)			−	1 (5.3)
	41–60%	5 (31.3)	7 (36.8)		5 (50.0)	8 (42.1)
	61–80%	3 (18.8)	6 (31.6)		3 (30.0)	5 (26.3)
	81–100%	5 (31.3)	6 (31.6)		2 (20.0)	5 (26.3)
	Do not know	−	−			−
Robotic approach: n (%)				0.409
	0–20%	14(87.5)	15 (79.0)		10 (100)	14(73.7)
	21–40%	−	2 (10.5)		−	2 (10.6)
	41–60%	−	−		−	−
	61–80%	−	−		−	−
	81–100%	−	−		−	−
	Do not know	2 (12.5)	2 (10.5)		−	2 (10.6)
Hospital with colorectal surgery dedicated group: n (%)				0.008	^ Not applicable. NA	^ Not applicable. NA
	Yes	11(68.8)	19 (100)		−	−
	No	5 (31.3)	−		−	−
	Do not know	−	−		−	−
Right colon cancer surgery
Number		23.67 ± 2.1	68.17 ± 30.4	0.001	^ Not applicable. NA	^ Not applicable. NA
Preferable approach: n (%)				0.068			0.295
	Open	3 (18.8)	−		1 (10.0)	−
	Laparoscopic	12 (75.0)	19 (100)		9 (90.0)	18 (94.7)
	Robotic	−	−		−	−
	Do not know / Prefer not to answer	1 (6.3)	−		−	1 (5.3)
Do you routinely resect the Gillot surgical stump? (duodenal window): n (%)				0.664			0.003
	Yes	10 (62.5)	9 (47.4)		2 (20.0)	12 (63.2)
	No	4 (25.0)	7 (36.8)		3 (30.0)	7 (36.8)
	Did not answer / Prefer not to answer	2 (12.5)	3 (15.8)		5 (50.0)	−
Does your institution have a standard anastomosis type? – n (%)				0.782			0.197
	Yes	12 (75.0)	15 (79.0)		9 (90.0)	13 (68.4)
	No	4 (25.0)	4 (21.1)		1 (10.0)	6 (31.6)
Anastomosis usually performed: n (%)				0.554			0.765
	Side-to-side (manual)	−	1 (5.3)		−	1 (5.3)
	Side-to-side (mechanical)	15 (93.8)	15 (79.0)		9 (90.0)	15 (79.0)
	End-to-side (mechanical)	1 (6.3)	2 (10.6)		1 (10.0)	2 (10.6)
	Other	−	1 (5.3)		−	1 (5.3)
Laparoscopic right hemicolectomy anastomosis: n (%)				0.553			0.009
	Intracorporeal	6 (37.5)	8 (42.1)		8 (80.0)	4 (21.1)
	Extracorporeal	9 (56.3)	10 (52.6)		2 (20.0)	14 (73.7)
	Both	−	1 (5.3)		−	1 (5.3)
	Did not answer / Prefer not to answer	1 (6.3)	−		−	−

		Dedicated group
		Yes (n = 31)	No (n = 5)	^* * Descriptive statistics were expressed as mean and standard deviation values, while categorical data were expressed as proportions. The associations among the variables were studied using the independent-sample Mann-Whitney U-test for continuous variables and Chi-squared tests for categorical data. p-value
Number of colorectal surgeries: mean ± standard deviation		162 ± 102	49 ± 19.5	0.001
Open approach: n (%)				0.107
	0–20%	12 (38.7)	1 (20.0)
	21–40%	11 (35.5)	1 (20.0)
	41–60%	7 (22.6)	2 (40.0)
	61–80%	−	1 (20.0)
	81–100%	1(3.2)	−
	Do not know	−	−
Laparoscopic approach: n (%)				0.620
	0–20%	1 (3.2)	1 (20.0)
	21–40%	1 (3.2)	−
	41–60%	11 (35.5)	2 (40.0)
	61–80%	8 (25.8)	1 (20.0)
	81–100%	10 (32.3)	1 (20.0)
	Do not know	−	−
Robotic approach: n (%)				0.409
	0–20%	27(87.1)	3 (60.0)
	21–40%	2 (6.5)	−
	41–60%	−	−
	61–80%	−	−
	81–100%	−	−
	Do not know	2 (6.5)	2 (40.0)
Right colon cancer surgery
Number: mean ± standard deviation		51.8 ± 32.6	23.8 ± 4.8	0.001
Preferable approach: n (%)				0.021
	Open	2 (6.5)	2 (40.0)
	Laparoscopic	29 (93.5)	3 (60.0)
	Robotic	−	−
	Do not know/Prefer not to answer	−	−
Vessel routinely ligated in right colon cancer surgery: n (%)				0.698
	Ileocolic vessels	2 (6.5)
	Right colic vessels (if present)	−	−
	Right branch of middle colic vessels	−	−
	Middle colic vessels	−	−
	All of the above	29 (93.5)	5 (100.0)
	Do not answer/Prefer not to answer
Do you routinely resect the Gillot surgical stump? (duodenal window) : n (%)				0.369
	Yes	10 (32.3)	1 (20.0)
	No	15 (48.4)	4 (80.0)
	Do not answer/Prefer not to answer	6 (19.4)	−
Does your institution have a standard anastomosis type? – n (%)				0.029
	Yes	26 (83.9)	2 (40.0)
	No	5 (16.1)	3 (60.0)
Anastomosis usually performed: n (%)				0.817
	Side-to-side (Manual)	1 (3.2)	−
	Side-to-side (mechanical)	26 (83.9)	5 (100.0)
	End-to-side (mechanical)	3 (9.7)	−
	Other	1 (3.2)	−
Laparoscopic right hemicolectomy anastomosis: n (%)				0.617
	Intracorporeal	14 (45.2)	1(20.0)
	Extracorporeal	15 (48.4)	4 (80.0)
	Both	1 (3.2)	−
	Do not answer/Prefer not to answer	1 (3.2)	-

[1] Address for correspondence
Miguel Fernandes da Conceição Cunha, Portimão Colorectal Surgery Group, Surgery II Department, Algarve Local Health Unit, Sitio do Poço Seco 8.500, Portimão, Portugal (email: Miguelcunha86@gmail.com).

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Abstract

Introduction

Materials and Methods

Results

Conclusion