Comparison of a low Hartmann's procedure with low colorectal anastomosis with and without defunctioning ileostomy after radiotherapy for rectal cancer: results from a national registry

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Frederik H W JonkerDutch Surgical Colorectal Audit Group

Abstract

This study used a national registry to compare the outcome after a low Hartmann's procedure (LHP), defined as removal of most of the rectum to leave a short anorectal stump and an end colostomy, and low anterior resection (LA) with or without a diverting ileostomy (DI) in rectal cancer patients all of whom had received preoperative neoadjuvant radiotherapy (RT). Patients who underwent LHP or LA with or without DI for rectal cancer after RT between 2009 and 2013 were identified from the Dutch Surgical Colorectal Audit. The postoperative outcome was compared between the three groups and risk of complications, reoperation and mortality were analysed in a multivariable model. The study included 4288 patients were included, of whom 27.8% underwent LHP, 20.2% LA and 52.0% LA with DI. Thirty-day mortality was higher after LHP (3.2% vs 1.3% and 1.3% for LA with or without DI, P < 0.001), but LHP was not an independent predictor of mortality in multivariable analysis. LHP and LA with DI were associated with a lower rate of abdominal infective complications (6.5% and 10.1% vs 16.2%, P < 0.001) and reoperation (7.3% and 8.1% vs 16.5%, P < 0.001). In multivariable analysis, LHP (OR 0.35, 95% CI 0.26-0.47) and LA with DI (OR 0.43, 95% CI 0....Continue Reading

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Citations

Mar 5, 2017·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·UNKNOWN Dutch Snapshot Research Group
Jan 23, 2018·International Journal of Colorectal Disease·Ingvar SverrissonKenneth Smedh
Mar 25, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·E WesterduinUNKNOWN Dutch Snapshot Research Group
Aug 17, 2020·World Journal of Surgical Oncology·Marcin ZemanAgnieszka Czarniecka
Aug 3, 2016·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Dieter Hahnloser
Nov 28, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Sapho X RoodbeenUNKNOWN Dutch Snapshot Research Group
Aug 12, 2021·Revista do Colégio Brasileiro de Cirurgiões·Anderson Rech LazzaronDaniel C Damin

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