Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Postoperative morbidity following Hartmann's procedure in comparison to anterior resection and abdominoperineal resection for rectal cancer—a population-based study

Mariusdottir, Elin LU ; Jörgren, Fredrik LU ; Lydrup, Marie Louise LU and Buchwald, Pamela LU (2024) In Colorectal Disease 26(6). p.1250-1257
Abstract

Aim: There is ongoing controversy regarding the extent to which Hartmann's procedure (HP) should be used in rectal cancer treatment. This study was designed to investigate 30-day postoperative morbidity and mortality following HP, anterior resection (AR) and abdominoperineal resection (APR) for rectal cancer using a national registry. Methods: All patients operated for rectal cancer, tumour height 5–15 cm, between the years 2010 and 2017, were identified through the Swedish colorectal cancer registry. Results: A total of 8476 patients were included: 1210 (14%) undergoing HP, 5406 (64%) AR and 1860 (22%) APR. HP was associated with an increased risk of intra-abdominal infection (OR 1.7, CI 1.26–2.28, P = 0.0004) compared to AR and APR,... (More)

Aim: There is ongoing controversy regarding the extent to which Hartmann's procedure (HP) should be used in rectal cancer treatment. This study was designed to investigate 30-day postoperative morbidity and mortality following HP, anterior resection (AR) and abdominoperineal resection (APR) for rectal cancer using a national registry. Methods: All patients operated for rectal cancer, tumour height 5–15 cm, between the years 2010 and 2017, were identified through the Swedish colorectal cancer registry. Results: A total of 8476 patients were included: 1210 (14%) undergoing HP, 5406 (64%) AR and 1860 (22%) APR. HP was associated with an increased risk of intra-abdominal infection (OR 1.7, CI 1.26–2.28, P = 0.0004) compared to AR and APR, while APR was related to an increased risk of overall complications (OR 1.18, CI 1.01–1.40, P = 0.040). No significant difference was observed in the rate of reoperations and readmissions between HP, AR and APR, and type of surgical procedure was not a risk factor for 30-day mortality. Findings from a subgroup analysis of patients with a tumour 5–7 cm from the anal verge revealed that HP was not associated with increased risk for complications or 30-day mortality. Conclusions: For patients where AR is not appropriate HP is a valid alternative with a favourable outcome. APR was associated with the highest overall 30-day complication rate.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
complications, Hartmann's procedure, intra-abdominal infection, rectal cancer
in
Colorectal Disease
volume
26
issue
6
pages
8 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:38802985
  • scopus:85194840792
ISSN
1462-8910
DOI
10.1111/codi.17033
language
English
LU publication?
yes
id
16d94cc2-196b-4815-926a-fbea5cb63c1e
date added to LUP
2024-10-09 15:28:51
date last changed
2025-07-03 15:02:21
@article{16d94cc2-196b-4815-926a-fbea5cb63c1e,
  abstract     = {{<p>Aim: There is ongoing controversy regarding the extent to which Hartmann's procedure (HP) should be used in rectal cancer treatment. This study was designed to investigate 30-day postoperative morbidity and mortality following HP, anterior resection (AR) and abdominoperineal resection (APR) for rectal cancer using a national registry. Methods: All patients operated for rectal cancer, tumour height 5–15 cm, between the years 2010 and 2017, were identified through the Swedish colorectal cancer registry. Results: A total of 8476 patients were included: 1210 (14%) undergoing HP, 5406 (64%) AR and 1860 (22%) APR. HP was associated with an increased risk of intra-abdominal infection (OR 1.7, CI 1.26–2.28, P = 0.0004) compared to AR and APR, while APR was related to an increased risk of overall complications (OR 1.18, CI 1.01–1.40, P = 0.040). No significant difference was observed in the rate of reoperations and readmissions between HP, AR and APR, and type of surgical procedure was not a risk factor for 30-day mortality. Findings from a subgroup analysis of patients with a tumour 5–7 cm from the anal verge revealed that HP was not associated with increased risk for complications or 30-day mortality. Conclusions: For patients where AR is not appropriate HP is a valid alternative with a favourable outcome. APR was associated with the highest overall 30-day complication rate.</p>}},
  author       = {{Mariusdottir, Elin and Jörgren, Fredrik and Lydrup, Marie Louise and Buchwald, Pamela}},
  issn         = {{1462-8910}},
  keywords     = {{complications; Hartmann's procedure; intra-abdominal infection; rectal cancer}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1250--1257}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Colorectal Disease}},
  title        = {{Postoperative morbidity following Hartmann's procedure in comparison to anterior resection and abdominoperineal resection for rectal cancer—a population-based study}},
  url          = {{http://dx.doi.org/10.1111/codi.17033}},
  doi          = {{10.1111/codi.17033}},
  volume       = {{26}},
  year         = {{2024}},
}