{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:22:44Z","timestamp":1786980164150,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007606","name":"Aarhus University Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007606","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The literature reports a varying occurrence (3\u201333%) of blowout of the rectal remnant after Hartmann\u2019s procedure, and there is a lack of multivariate analyses on potential risk factors for blowout following Hartmann\u2019s procedure. We aimed to estimate the incidence of blowout within 90\u00a0days after a primary Hartmann\u2019s procedure and to identify potential risk factors for blowout through multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at the Department of Surgery, Aarhus University Hospital, a Danish primary and tertiary hospital. Patients who underwent primary surgery with Hartmann\u2019s procedure irrespective of surgical setting and indications between September 2016 and August 2021 were included. Blowout was defined as a defective closure line of the rectal stump or a pelvic abscess.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 178 patients were included, and blowout occurred in 30 patients (16.9%) within 90\u00a0days after a primary Hartmann\u2019s procedure. Multivariate analysis showed increased risk of blowout among patients with Hinchey IV diverticulitis (relative risk 6.32 (95% CI 4.09\u20139.75)), previous radiotherapy (relative risk 3.35 (95% CI 1.67\u20136.74)), and alcohol overconsumption (relative risk 1.69 (95% CI 1.05\u20132.72)). Intraoperative insertion of a Foley catheter in the rectal remnant significantly reduced the risk of blowout within 90\u00a0days after a primary Hartmann\u2019s procedure (relative risk 0.18 (95% CI 0.05\u20130.65)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Blowout remains a severe and common complication within 90\u00a0days after a primary Hartmann\u2019s procedure. Hinchey IV diverticulitis, pelvic radiotherapy, and alcohol overconsumption are risk factors. An intraoperatively inserted rectal Foley catheter is a protective factor and can be considered used in all patients undergoing Hartmann\u2019s procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-023-02967-5","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T22:01:31Z","timestamp":1689285691000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Incidence and risk factors of blowout within 90\u00a0days after a primary Hartmann\u2019s procedure: a retrospective cohort study"],"prefix":"10.1007","volume":"408","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1879-3884","authenticated-orcid":false,"given":"Josefine","family":"Secher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogini","family":"Balachandran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene Hjerrild","family":"Iversen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"issue":"4","key":"2967_CR1","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1308\/rcsann.2018.0006","volume":"100","author":"S Hallam","year":"2018","unstructured":"Hallam S, Mothe BS, Tirumulaju R (2018) Hartmann\u02bcs procedure, reversal and rate of stoma-free survival. 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