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Editorial
Colorectal cancer
 Less is more: simplifying patient-centered cancer care
In Ja Parkorcid
Annals of Coloproctology 2025;41(3):173-174.
DOI: https://doi.org/10.3393/ac.2025.00738.0105
Published online: June 30, 2025

Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence to: In Ja Park, MD, PhD Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Email: ipark@amc.seoul.kr
• Received: June 8, 2025   • Accepted: June 8, 2025

© 2025 The Korean Society of Coloproctology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Reducing unnecessary treatments and optimizing preoperative general condition not only improves therapeutic efficiency but also significantly enhances patients' quality of life. Medicine should aim to maintain a balance, emphasizing both survival and patient comfort and dignity. This balance is not merely practical but represents an ethical commitment to patients' overall well-being [1–3].
Recently, managing urinary dysfunction following rectal cancer surgery has received increased attention, especially with Enhanced Recovery After Surgery (ERAS) protocols. The randomized controlled trial by Gricius et al. [4], "Early urinary catheter removal in patients undergoing rectal cancer surgery: a randomized controlled trial on silodosin versus no drug action on urinary function in early postoperative period," examined the potential benefits of silodosin for enhancing early postoperative urinary recovery.
This prospective trial evaluated the use of silodosin, an α-blocker, to facilitate the early removal of urinary catheters, potentially reducing patient discomfort, hospital stays, and infection risks. Although no significant statistical difference was found in postvoid residual volume or urinary retention rates between the silodosin and control groups, the silodosin group exhibited a slightly lower retention rate, suggesting a potential clinical advantage. The study also confirmed the safety of early catheter removal under the tested protocol.
Practically, this study demonstrates that early catheter removal is both feasible and safe for rectal cancer patients within ERAS protocols. The potential of silodosin to aid this process remains clinically intriguing. Despite lingering concerns regarding urinary retention after rectal surgery, the benefit of early urinary catheter removal for reducing urinary tract infections has been well documented [5–8]. Several studies have already demonstrated silodosin’s effectiveness as an α-blocker in preventing acute urinary retention in patients with prostatic disease [9, 10]. Gricius et al. [4] expanded this indication by investigating silodosin in postoperative rectal cancer patients, confirming its possible efficacy in this small-scale study. These preliminary findings could provide the groundwork for larger-scale studies to build stronger evidence supporting the use of α-adrenoreceptor antagonists in postoperative care for rectal cancer patients. Furthermore, the study contributes to existing research by highlighting urinary function, which is a critical yet frequently overlooked component of postoperative quality of life. As rectal cancer treatment evolves toward more personalized approaches, supportive strategies such as optimizing urinary function should remain a priority.
However, the study has notable limitations in its design. Although described as "double-blind," evaluators were not blinded, which introduces potential bias, especially regarding subjective assessments and decisions related to catheter reinsertion. As indicated by CONSORT (Consolidated Standards of Reporting Trials) guidelines, both patients and outcome assessors should be blinded to maintain the integrity of the study [11]. Additionally, the relatively small sample size restricts the generalizability of these results, and the absence of significant differences might reflect insufficient statistical power. Larger, multicenter trials are necessary to provide more definitive results and clearer clinical guidance.
In summary, while this study offers important insights into the role of silodosin and supports the safety of early catheter removal, methodological limitations—particularly the lack of evaluator blinding—should be addressed in future research. Larger and more rigorously blinded studies are required to confirm these findings. Nevertheless, this research significantly contributes to enhancing postoperative care for rectal cancer patients and underscores the ongoing refinement of ERAS protocols.

Conflict of interest

In Ja Park is the current editor-in-chief of this journal. No other potential conflict of interest relevant to this article was reported.

Funding

None.

  • 1. Weets V, Meillat H, Saadoun JE, Dazza M, de Chaisemartin C, Lelong B. Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer. Ann Coloproctol 2024;40:440–50. ArticlePubMedPMCPDF
  • 2. Wee IJY, Seow-En I, Chok AY, Sim E, Koo CH, Lin W, et al. Postoperative outcomes after prehabilitation for colorectal cancer patients undergoing surgery: a systematic review and meta-analysis of randomized and nonrandomized studies. Ann Coloproctol 2024;40:191–9. ArticlePubMedPMCPDF
  • 3. Wu J, Chi H, Kok S, Chua JM, Huang XX, Zhang S, et al. Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery. Ann Coloproctol 2024;40:3–12. ArticlePubMedPMCPDF
  • 4. Gricius Z, Kuliavas J, Stratilatovas E, Buckus B, Dulskas A. Early urinary catheter removal in patients undergoing rectal cancer surgery: a randomized controlled trial on silodosin versus no pharmacological treatment on urinary function in the early postoperative period. Ann Coloproctol 2025;41:239–45. Article
  • 5. Kwaan MR, Lee JT, Rothenberger DA, Melton GB, Madoff RD. Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum 2015;58:401–5. ArticlePubMed
  • 6. Castelo M, Sue-Chue-Lam C, Kishibe T, Acuna SA, Baxter NN. Early urinary catheter removal after rectal surgery: systematic review and meta-analysis. BJS Open 2020;4:545–53. ArticlePubMedPMCPDF
  • 7. Ye F, Ruan L, Liu Z, Xie H, Wan T, Zhu W, et al. Postoperative urinary retention following transanal versus laparoscopic total mesorectal excision for rectal cancer: a randomized trial report from an experienced center. Heliyon 2024;10:e34753. ArticlePubMedPMC
  • 8. Meillat H, Magallon C, Brun C, de Chaisemartin C, Moureau-Zabotto L, Bonnet J, et al. Systematic early urinary catheter removal integrated in the full Enhanced Recovery After Surgery (ERAS) protocol after laparoscopic mid to lower rectal cancer excision: a feasibility study. Ann Coloproctol 2021;37:204–11. ArticlePubMedPMCPDF
  • 9. Gwon YN, Park JJ, Yang WJ, Doo SW, Kim JH, Kim DK. Comparing effects of alpha-blocker management on acute urinary retention secondary to benign prostatic hyperplasia: a systematic review and network meta-analysis. Prostate Int 2023;11:91–9. ArticlePubMedPMC
  • 10. Fisher E, Subramonian K, Omar MI. The role of alpha blockers prior to removal of urethral catheter for acute urinary retention in men. Cochrane Database Syst Rev 2014;2014:CD006744.ArticlePubMedPMC
  • 11. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c869.ArticlePubMedPMC

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        Less is more: simplifying patient-centered cancer care
        Ann Coloproctol. 2025;41(3):173-174.   Published online June 30, 2025
        DOI: https://doi.org/10.3393/ac.2025.00738.0105
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