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Low Incidence of Pelvic Sepsis after Hartmann's Procedure : Radiation Therapy May Be a Risk Factor

Wetterhall, Carmela ; Mariusdottir, Elin LU ; Hall, Claire ; Jörgren, Fredrik LU and Buchwald, Pamela LU (2019) In Gastrointestinal tumors 5(3-4). p.77-81
Abstract

Purpose: Hartmann's procedure is a well-established alternative in colorectal surgery when a primary anastomosis is contraindicated. However, the rectal remnant may cause complications. This study was designed to investigate the occurrence of pelvic sepsis after Hartmann's procedure and identify possible risk factors.

Methods: All patients who underwent Hartmann's procedure between 2005 and 2012 were identified by the in-hospital registry. Information about pelvic sepsis and potential preoperative, perioperative, and postoperative risk factors was obtained by review of the medical records.

Results: 172 patients were identified (97 females); they were aged 74 ± 11 years. Surgery was performed due to cancer (49%) or... (More)

Purpose: Hartmann's procedure is a well-established alternative in colorectal surgery when a primary anastomosis is contraindicated. However, the rectal remnant may cause complications. This study was designed to investigate the occurrence of pelvic sepsis after Hartmann's procedure and identify possible risk factors.

Methods: All patients who underwent Hartmann's procedure between 2005 and 2012 were identified by the in-hospital registry. Information about pelvic sepsis and potential preoperative, perioperative, and postoperative risk factors was obtained by review of the medical records.

Results: 172 patients were identified (97 females); they were aged 74 ± 11 years. Surgery was performed due to cancer (49%) or diverticulitis (35%) and other benign disease (16%). Rectal transection was carried out anywhere between the pelvic floor and the promontory. Pelvic sepsis developed in 6.4% (11/172) of patients. Pelvic sepsis was associated with preoperative radiotherapy (p = 0.03) and Hinchey grade III and IV (p = 0.02) in those patients who underwent Hartmann's procedure for diverticular disease.

Conclusion: Hartmann's procedure is a safe operation when an anastomosis is contraindicated since the incidence of pelvic sepsis is low. Preoperative radiotherapy and Hinchey grade III and IV may be risk factors for the development of pelvic sepsis.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
Gastrointestinal tumors
volume
5
issue
3-4
pages
5 pages
publisher
Karger
external identifiers
  • pmid:30976578
ISSN
2296-3774
DOI
10.1159/000493526
language
English
LU publication?
no
id
703ad13d-543e-42d3-90d1-d62525165000
date added to LUP
2021-12-29 12:12:58
date last changed
2021-12-30 08:53:57
@article{703ad13d-543e-42d3-90d1-d62525165000,
  abstract     = {{<p>Purpose: Hartmann's procedure is a well-established alternative in colorectal surgery when a primary anastomosis is contraindicated. However, the rectal remnant may cause complications. This study was designed to investigate the occurrence of pelvic sepsis after Hartmann's procedure and identify possible risk factors.</p><p>Methods: All patients who underwent Hartmann's procedure between 2005 and 2012 were identified by the in-hospital registry. Information about pelvic sepsis and potential preoperative, perioperative, and postoperative risk factors was obtained by review of the medical records.</p><p>Results: 172 patients were identified (97 females); they were aged 74 ± 11 years. Surgery was performed due to cancer (49%) or diverticulitis (35%) and other benign disease (16%). Rectal transection was carried out anywhere between the pelvic floor and the promontory. Pelvic sepsis developed in 6.4% (11/172) of patients. Pelvic sepsis was associated with preoperative radiotherapy (p = 0.03) and Hinchey grade III and IV (p = 0.02) in those patients who underwent Hartmann's procedure for diverticular disease.</p><p>Conclusion: Hartmann's procedure is a safe operation when an anastomosis is contraindicated since the incidence of pelvic sepsis is low. Preoperative radiotherapy and Hinchey grade III and IV may be risk factors for the development of pelvic sepsis.</p>}},
  author       = {{Wetterhall, Carmela and Mariusdottir, Elin and Hall, Claire and Jörgren, Fredrik and Buchwald, Pamela}},
  issn         = {{2296-3774}},
  language     = {{eng}},
  number       = {{3-4}},
  pages        = {{77--81}},
  publisher    = {{Karger}},
  series       = {{Gastrointestinal tumors}},
  title        = {{Low Incidence of Pelvic Sepsis after Hartmann's Procedure : Radiation Therapy May Be a Risk Factor}},
  url          = {{http://dx.doi.org/10.1159/000493526}},
  doi          = {{10.1159/000493526}},
  volume       = {{5}},
  year         = {{2019}},
}