Low risk of intra-abdominal infections in rectal cancer patients treated with Hartmann's procedure: a report from a national registry

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Sverrisson, IngvarUppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås (författare)

Low risk of intra-abdominal infections in rectal cancer patients treated with Hartmann's procedure : a report from a national registry

Artikel/kapitelEngelska2018

Förlag, utgivningsår, omfång ...

2018-01-21
SPRINGER,2018
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-347541
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-347541URI
https://doi.org/10.1007/s00384-018-2967-0DOI

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Språk:engelska
Sammanfattning på:engelska

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Anmärkningar

To describe the postoperative surgical complications in patients with rectal cancer undergoing Hartmann's procedure (HP). Data were retrieved from the Swedish Colorectal Cancer Registry for all patients with rectal cancer undergoing HP in 2007-2014. A retrospective analysis was performed using prospectively recorded data. Characteristics of patients and risk factors for intra-abdominal infection and re-laparotomy were analysed. Of 10,940 patients resected for rectal cancer, 1452 (13%) underwent HP (median age, 77 years). The American Society of Anesthesiologists (ASA) score was 3-4 in 43% of patients; 15% had distant metastases and 62% underwent a low HP. The intra-abdominal infection rate was 8% and re-laparotomy rate was 10%. Multivariable logistic regression analysis identified preoperative radiotherapy (OR, 1.78; 95% CI, 1.14-2.77), intra-operative bowel perforation (OR, 1.99; 95% CI, 1.08-3.67), T4 tumours (OR, 1.68; 95% CI 1.04-2.69) and female gender (OR, 1.73; 95% CI, 1.15-2.61) as risk factors for intra-abdominal infection. ASA score 3-4 (OR, 1.62; 95% CI, 1.12-2.34), elevated BMI (OR, 1.05; 95% CI, 1.02-1.09) and female gender (OR, 2.06; CI, 1.41-3.00) were risk factors for re-laparotomy after HP. The rate of intra-abdominal infection was not increased after a low HP. Despite older age and co-morbidities including more advanced cancer, patients undergoing Hartmann's procedure had low rates of serious postoperative complications and re-laparotomy. A low HP was not associated with a higher rate of intra-abdominal infection. HP seems to be appropriate for old and frail patients with rectal cancer.

Ämnesord och genrebeteckningar

Rectal cancer
Surgery
Hartmann's procedure
Postoperative complications
Intra-abdominal infections

Biuppslag (personer, institutioner, konferenser, titlar ...)

Hosseinali Khani, Maziar,1975-Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås(Swepub:uu)mazho292 (författare)
Chabok, Abbas,1964-Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås(Swepub:uu)abbch956 (författare)
Smedh, KennetUppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås(Swepub:uu)kensm722 (författare)
Uppsala universitetKolorektalkirurgi (creator_code:org_t)

Sammanhörande titlar

Ingår i:International Journal of Colorectal Disease: SPRINGER33:3, s. 327-3320179-19581432-1262

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International Journal of Colorectal Disease (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Sverrisson, Ingv ...; Hosseinali Khani ...; Chabok, Abbas, 1 ...; Smedh, Kennet

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Av lärosätet: Uppsala universitet

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