scholarly journals Low Incidence of Pelvic Sepsis Following Hartmann’s Procedure for Rectal Cancer – A Retrospective Multicentre Study

2021 ◽  
Author(s):  
Elin Mariusdottir ◽  
Fredrik Jörgren ◽  
Amelia Mondlane ◽  
Jens Wikström ◽  
Marie-Louise Lydrup ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Significant Risk ◽  
Hartmann’S Procedure ◽  
Pelvic Sepsis ◽  
Major Surgery ◽  
Neoadjuvant Radiotherapy ◽  
Hartmann's Procedure ◽  
Sepsis Risk ◽  
Low Incidence

Abstract Background Results of previous studies regarding pelvic sepsis after Hartmann’s procedure (HP) for rectal cancer have been inconsistent and few studies report the risk factors. This study aimed to investigate the incidence of pelvic sepsis after HP, identify risk factors and describe when as well as how pelvic sepsis was diagnosed and treated. Methods Data were collected from the Swedish Colorectal Cancer Registry on all patients undergoing HP for rectal cancer in the county of Skåne from 2007–2017. Patients diagnosed with pelvic sepsis were compared with patients without pelvic sepsis and risk factors for developing pelvic sepsis were analysed in a multivariable model. Results A total of 252 patients were included in the study, with 149 (59%) males, and a median age of 75 years (range 20–92). Altogether, 27 patients (11%) were diagnosed with pelvic sepsis. Risk factors for developing pelvic sepsis were neoadjuvant radiotherapy (OR 7.96, 95% CI 2.54–35.36) and BMI over 25 kg/m2 (OR 5.26, 95% CI 1.80–19.50). Median time from operation to diagnosis was 21 days (range 5-355) with 11 (40%) patients diagnosed beyond 30 days postoperatively. The majority of cases 19 (70%) were treated conservatively and none needed major surgery. Conclusion Pelvic sepsis occurred in 11% of patients. Neoadjuvant radiotherapy and higher BMI were significant risk factors for developing pelvic sepsis. Forty percent of patients were diagnosed later than 30 days postoperatively and most patients were successfully treated conservatively. Our findings suggest that HP is a valid treatment option for rectal cancer when anastomosis is inappropriate, even in patients receiving neoadjuvant radiotherapy.

scholarly journals Low Incidence of Pelvic Sepsis after Hartmann’s Procedure: Radiation Therapy May Be a Risk Factor

2018 ◽  
Vol 5 (3-4) ◽  
pp. 77-81 ◽  
Author(s):  
Carmela Wetterhall ◽  
Elin Mariusdottir ◽  
Claire Hall ◽  
Fredrik Jörgren ◽  
Pamela Buchwald
Keyword(s):  
Radiation Therapy ◽  
Risk Factor ◽  
Hartmann’S Procedure ◽  
Pelvic Sepsis ◽  
Hartmann's Procedure ◽  
Low Incidence

Neoadjuvant Radiotherapy Versus Surgery Alone for Stage II/III Mid-low Rectal Cancer With or Without High-risk Factors

2019 ◽  
Vol 272 (6) ◽  
pp. 1060-1069 ◽  
Author(s):  
Xiangbing Deng ◽  
Ping Liu ◽  
Dan Jiang ◽  
Mingtian Wei ◽  
Xin Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
High Risk ◽  
Low Rectal Cancer ◽  
Stage Ii ◽  
Neoadjuvant Radiotherapy ◽  
High Risk Factors

scholarly journals Risk factors for esophageal cancer in a low-incidence area of Brazil

2013 ◽  
Vol 131 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Orlando Milhomem Mota ◽  
Maria Paula Curado ◽  
José Carlos Oliveira ◽  
Edesio Martins ◽  
Daniela Medeiros Milhomem Cardoso
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Risk Factor ◽  
Rural Areas ◽  
Significant Risk ◽  
Oral Sex ◽  
Chi Square ◽  
Chi Square Test ◽  
Low Incidence ◽  
Control Study

CONTEXT AND OBJECTIVESEsophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area.DESIGN AND SETTINGCase-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls.METHODSThe variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals.RESULTSThe risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer.CONCLUSIONIn a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.

scholarly journals Low Hartmann’s procedure or intersphincteric proctectomy for distal rectal cancer: a retrospective comparative cohort study

2017 ◽  
Vol 32 (11) ◽  
pp. 1583-1589 ◽  
Author(s):  
Emma Westerduin ◽  
Gijsbert D. Musters ◽  
Anna A. W. van Geloven ◽  
Marinke Westerterp ◽  
Erwin van der Harst ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cohort Study ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Distal Rectal Cancer ◽  
Comparative Cohort Study

Evaluation of risk factors for postoperative complications in rectal cancer patients

2020 ◽  
Vol 92 (4) ◽  
pp. 1-5
Author(s):  
Marcin Zeman ◽  
Marek Czarnecki ◽  
Maciej Grajek ◽  
Adam Idasiak ◽  
Andrzej Tukiendorf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Rectal Cancer ◽  
Coronary Artery ◽  
Postoperative Complications ◽  
Significant Risk ◽  
Neutrophil To Lymphocyte Ratio ◽  
Anastomotic Leaks ◽  
Lymphocyte Ratio ◽  
Artery Disease

Purpose The complications of surgical treatment for rectal cancer, particularly anastomotic leaks after anterior resection, are a significant clinical problem. We retrospectively analysed preoperative factors that may affect the occurrence of complications. Material and methods A total of 392 rectal cancer patients were included in a retrospective analysis. A total of 257 anterior resections (AR) and 135 abdominoperineal resections (APR) were performed. The risk factors for early postoperative complications were analysed by logistic regression and receiver operating characteristic curves. Results The significant risk factors for severe complications (grade 3B and higher on the Clavien-Dindo scale) in the multivariate analysis were neutrophil to lymphocyte ratio > 5 (p = 0.047) in the AR group, age of the patients (p = 0.031) in the APR group, and coronary artery disease in both groups (p = 0.03, p = 0.011, respectively). There were no risk factors for anastomotic leaks in the AR group before the analysis was divided into early and late leaks. In the univariate analysis, the statistically significant risk factors for early leaks were preoperative neutrophil to lymphocyte ratio > 5 and peripheral blood platelet count, while late leaks were associated with coronary artery disease; however, in the multivariate analysis, these factors were not statistically significant. Conclusions The risk factors for severe postoperative complications were neutrophil to lymphocyte ratio> 5, advanced age of the patients and coronary artery disease. The different risk factors for early and late anastomotic leaks after anterior resection may indicate their different aetiologies.

scholarly journals The role of Hartmann’s procedure in the elective management of rectal cancer: results of a Brazilian cohort study

2021 ◽  
Vol 48 ◽  
Author(s):  
ANDERSON RECH LAZZARON ◽  
INGRID SILVEIRA ◽  
PAULINE SIMAS MACHADO ◽  
DANIEL C DAMIN
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Surgical Complications ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Hartmann’S Procedure ◽  
Septic Complications ◽  
Elective Resection ◽  
Defunctioning Stoma ◽  
Hartmann's Procedure

ABSTRACT Background: although preservation of bowel continuity is a major goal in rectal cancer surgery, a colorectal anastomosis may be considered an unacceptably high-risk procedure, particularly for patients with multiple comorbidities. We aimed to assess rates of surgical complications in rectal cancer patients according to the type of procedure they had undergone. Materials and Methods: this cohort included all rectal cancer patients undergoing elective resection at a referral academic hospital over 16 years. There were three study groups according to the type of performed operation: (1) rectal resection with anastomosis without defunctioning stoma (DS); (2) rectal resection with anastomosis and DS; and (3) Hartmann’s procedure (HP). Postoperative complications and clinical outcomes were assessed. Results: four-hundred and two patients were studied. The 118 patients in group 3 were significantly older (>10 years), had higher Charlson Comorbidity Index scores, and more ASA class ≥3 than patients in the other two groups. Sixty-seven patients (16.7%) had Clavien-Dindo complications grade ≥ III, corresponding to an incidence of 11.8%, 20.9%, and 14.4% in groups 1, 2, and 3, respectively (p=0.10). Twenty-nine patients (7.2%) had major septic complications that required reoperation, with an incidence of 10.8%, 8.2% and 2.5% in groups 1, 2 and 3, respectively (p=0.048). Twenty-one percent of the group 2 patients did not undergo the stoma closure after a 24-month follow-up. Conclusion: HP was associated with a lower incidence of reoperation due to intra-abdominal septic complications. This procedure remains an option for patients in whom serious surgical complications are anticipated.

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