ArticleLangenbeck's archives of surgery2026
Intersphincteric abdominoperineal excision versus low Hartmann's procedure in the robotic era: a single institution experience.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
purposeNon-restorative surgical options for rectal cancer patients when primary anastomosis is not suitable, Hartmann's procedure (HP) or intersphincteric abdominoperineal excision (IAPE) are common. Previous studies suggest higher pelvic sepsis after HP, but no data exist comparing exclusively robot-assisted approaches.
methodsThis retrospective study included rectal cancer patients with significant comorbidities precluding anastomosis. Those patients underwent robot-assisted HP or IAPE at Odense University Hospital (2012-2022). Demographic, 30-day postoperative medical and surgical complications, reoperation, readmission, and 90-day mortality were analysed.
resultsA total 224 patients were included (HP: n = 57; IAPE: n = 167), HP patients were older (77.0 ± 9.3 vs. 71.7 ± 11.5 years, p = 0.002) and had higher ASA scores (p = 0.001). Postoperative medical complications were low and comparable in both groups. Intra abdominal abscess was also comparable (3.5% for HP vs. 5.4% for IAPE, p = 0.832) Perineal wound infection still present in the IAPE group (6.6%) and perineal pain at 14 day was relatively high (11.4%) after IAPE. No significant difference was observed in the rate of readmission, reoperation and 90-day mortality.
conclusionComplications rates did not significantly differ between HP and IAPE. However, IAPE was associated with perineal wound-related morbidity. In patents unfit for anastomosis, robot-assisted HP may considered a better and safer alternative for IAPE.
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