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Hartmann’s procedur...
Hartmann’s procedure in rectal cancer surgery is often an intraoperative decision : a retrospective multicenter study
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- Mariusdottir, Elin (författare)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Helsingborg Hospital
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- Jörgren, Fredrik (författare)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kirurgi,Forskargrupper vid Lunds universitet,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Surgery,Lund University Research Groups,Helsingborg Hospital
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- Saeed, Maria (författare)
- Skåne University Hospital
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- Wikström, Jens (författare)
- Lund University,Central Hospital Kristianstad
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- Lydrup, Marie Louise (författare)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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- Buchwald, Pamela (författare)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital
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(creator_code:org_t)
- 2024
- 2024
- Engelska.
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Ingår i: Langenbeck's Archives of Surgery. - 1435-2443. ; 409:1
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Purpose: This study aimed to investigate patient-related factors predicting the selection of rectal cancer patients to Hartmann’s procedure as well as to investigate how often, and on what grounds, anterior resection is intraoperatively changed to Hartmann’s procedure. Methods: Prospectively collected data from the Swedish Colorectal Cancer Registry regarding patients with rectal cancer operated upon from January 1 2007 to June 30 2017 in the county of Skåne were retrospectively reviewed. Data were expanded with further details from medical charts. A univariable analysis was performed to investigate variables associated with unplanned HP and significant variables included in a multivariable logistic regression analysis. Results: Altogether, 1141 patients who underwent Hartmann’s procedure (275 patients, 24%), anterior resection (491 patients, 43%), or abdominoperineal resection (375 patients, 33%) were included. Patients undergoing Hartmann’s procedure were significantly older and had more frequently comorbidity. The decision to perform Hartmann’s procedure was made preoperatively in 209 (76%) patients, most commonly because of a comorbidity (27%) or oncological reasons (25%). Patient preference was noted in 8% of cases. In 64 cases (23%), the decision was made intraoperatively, most often due to anastomotic difficulties (60%) and oncological reasons (22%). Anastomotic difficulties were most often reported due to technical difficulties, a low tumor or neoadjuvant radiotherapy. Male gender was a significant risk factor for undergoing unplanned Hartmann’s procedure. Conclusions: The decision to perform Hartmann’s procedure was frequently made intraoperatively. Hartmann’s procedure should be considered and discussed preoperatively in old and frail patients, especially in the presence of mid-rectal cancer and/or male gender, since these factors increase the risk of intraoperative anastomotic difficulties.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Hartmann’s procedure
- Intraoperative decision
- Rectal cancer
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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