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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Fältnamn	Indikatorer	Metadata
000		03680naa a2200397 4500
001		oai:DiVA.org:uu-347541
003		SwePub
008		180409s2018 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3475412 URI
024	7	a https://doi.org/10.1007/s00384-018-2967-02 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Sverrisson, Ingvaru Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås4 aut0 (Swepub:uu)ingsv803
245	1 0	a Low risk of intra-abdominal infections in rectal cancer patients treated with Hartmann's procedure :b a report from a national registry
264		c 2018-01-21
264	1	b SPRINGER,c 2018
338		a electronic2 rdacarrier
520		a 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.
653		a Rectal cancer
653		a Surgery
653		a Hartmann's procedure
653		a Postoperative complications
653		a Intra-abdominal infections
700	1	a Hosseinali Khani, Maziar,d 1975-u Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås4 aut0 (Swepub:uu)mazho292
700	1	a Chabok, Abbas,d 1964-u Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås4 aut0 (Swepub:uu)abbch956
700	1	a Smedh, Kennetu Uppsala universitet,Kolorektalkirurgi,Centrum för klinisk forskning, Västerås4 aut0 (Swepub:uu)kensm722
710	2	a Uppsala universitetb Kolorektalkirurgi4 org
773	0	t International Journal of Colorectal Diseased : SPRINGERg 33:3, s. 327-332q 33:3<327-332x 0179-1958x 1432-1262
856	4	u https://doi.org/10.1007/s00384-018-2967-0y Fulltext
856	4	u https://uu.diva-portal.org/smash/get/diva2:1196044/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4	u https://link.springer.com/content/pdf/10.1007/s00384-018-2967-0.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-347541
856	4 8	u https://doi.org/10.1007/s00384-018-2967-0

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