{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:13:43Z","timestamp":1790259223073,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Stig och Ragna Gorthon Stiftelse","award":["2021-2732"],"award-info":[{"award-number":["2021-2732"]}]},{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","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><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>This study aimed to investigate patient-related factors predicting the selection of rectal cancer patients to Hartmann\u2019s procedure as well as to investigate how often, and on what grounds, anterior resection is intraoperatively changed to Hartmann\u2019s procedure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Prospectively 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 Sk\u00e5ne 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.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Altogether, 1141 patients who underwent Hartmann\u2019s procedure (275 patients, 24%), anterior resection (491 patients, 43%), or abdominoperineal resection (375 patients, 33%) were included. Patients undergoing Hartmann\u2019s procedure were significantly older and had more frequently comorbidity. The decision to perform Hartmann\u2019s 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\u2019s procedure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The decision to perform Hartmann\u2019s procedure was frequently made intraoperatively. Hartmann\u2019s 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.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-024-03237-8","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T04:41:45Z","timestamp":1707280905000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Hartmann\u2019s procedure in rectal cancer surgery is often an intraoperative decision: a\u00a0retrospective multicenter study"],"prefix":"10.1007","volume":"409","author":[{"given":"Elin","family":"Mariusdottir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"J\u00f6rgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Saeed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Louise","family":"Lydrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Buchwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"issue":"10","key":"3237_CR1","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1002\/bjs.1800691019","volume":"69","author":"RJ Heald","year":"1982","unstructured":"Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery\u2014the clue to pelvic recurrence? 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The board of the SCRCR granted permission to access the raw data after ethical approval. Before release of healthcare data from Region Sk\u00e5ne, the research plan is reviewed. All patients in Sweden treated for colorectal cancer receive information about being registered in the SCRCR and being part of future studies. Patients who do not wish to participate are excluded. This study was therefore approved without obtaining further consent from the patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The funding sources were not involved in study design, analysis, interpretation, writing, or submission of the manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}],"article-number":"55"}}