ArticleLangenbeck's archives of surgery2024
Hartmann's procedure in rectal cancer surgery is often an intraoperative decision: a retrospective multicenter study.
Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prophylactic funnel mesh for preventing parastomal hernia in patients with permanent end stoma: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2025Pooled it
- Trial
- Long-term disease-free survival in young-onset rectal cancer patients surgically treated with curative intent: a retrospective cohort study.International journal of colorectal disease · 2026Article
- Sigmoid diverticulitis mimicking colorectal cancer: A case report.Radiology case reports · 2026Article
- Total mesorectal excision quality as a predictor of overall survival in rectal cancer: A retrospective cohort study.Turkish journal of surgery · 2026Article
- Article
- Therapeutic effects of Buzhong Yiqi decoction in patients with spleen and stomach qi deficiency after routine surgery and chemotherapy for colorectal cancer.World journal of gastrointestinal surgery · 2024Article
- Long-term Quality of Life After Surgery for Mid- and High Rectal Cancer: Hartmann's ProcedureIn vivo (Athens, Greece)Article
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Authors and funding
6 authors.
Funding
Abstract
purposeThis 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.
methodsProspectively 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.
resultsAltogether, 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.
conclusionsThe 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.
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