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Background  To reduce local recurrence risk, rectal washout (RW) is integrated in the total mesorectal excision (TME) technique when performing anterior resection (AR) for rectal cancer. Although RW is considered a safe practice, data on the complication risk are scarce. Our aim was to examine the association between RW and 30-day postoperative complications after AR for rectal cancer.    Methods  Patients from the Swedish Colorectal Cancer Registry who underwent AR between 2007 and 2013 were analysed using multivariable methods.    Results  A total of 4821 patients were included (4317 RW, 504 no RW). The RW group had lower rates of overall complications (1578/4317 (37%) vs. 208/504 (41%),  p  = 0.039), surgical complications (879/4317 (20%) vs. 140/504 (28%),  p  < 0.001) and 30-day mortality (50/4317 (1.2%) vs. 12/504 (2.4%),  p  = 0.020). In multivariable analysis, RW was a risk factor neither for overall complications (OR 0.73, 95% CI 0.60–0.90,  p  = 0.002) nor for surgical complications (OR 0.62, 95% CI 0.50–0.78,  p  < 0.001).    Conclusions  RW is a safe technique that does not increase the 30-day postoperative complication risk after AR with TME technique for rectal cancer.

Rectal washout does not increase the complication risk after anterior resection for rectal cancer