{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:42:16Z","timestamp":1790088136322,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010restorative options for low rectal cancer not invading the sphincter includes low Hartmann's procedure (LH) and inter\u2010sphincteric abdominoperineal resection (ISAPR). There is currently little comparative data to differentiate these options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this review was to assess the peri\u2010operative morbidity of LH, and then to compare it to that of ISAPR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>An up\u2010to\u2010date systematic review was performed on the available literature between 2000\u20132020 on PubMed, EMBASE, Medline, and Cochrane Library databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Selection<\/jats:title><jats:p>All studies reporting on non\u2010restorative surgeries for rectal cancer were analysed. Outcomes were firstly analysed between LH and non\u2010LH groups, with further sub\u2010analysis comparing the LH and ISAPR groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>The main outcome measures were the rates of pelvic sepsis, rates of overall post\u2010operative complication rates, oncological outcomes, and survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12 observational studies were included. There were 3526 patients (61.1%) in the LH group, and 2238 patients (38.9%) in the non\u2010LH group, which included 461 patients who underwent ISAPR. The LH group had a higher rate of pelvic sepsis as compared to the non\u2010LH group (OR: 1.79, 95% CI: 1.39\u20132.29, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The difference is more marked in the sub\u2010analysis comparing LH and ISAPR alone (OR: 3.94, 95% CI: 1.88\u20137.84, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) corresponding to a higher rate of unplanned re\u2010intervention. LH was associated with a higher rate of short\u2010term post\u2010operative mortality as compared to the non\u2010LH group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ISAPR is the preferred option for non\u2010restorative rectal surgery, with a more favourable peri\u2010operative morbidity and short\u2010term mortality profile as compared to LH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17827","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T13:14:47Z","timestamp":1655817287000},"page":"2829-2839","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The complication profile of low Hartmann's in rectal cancer: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-5742","authenticated-orcid":false,"given":"Kay Tai","family":"Choy","sequence":"first","affiliation":[{"name":"Department of Surgery Austin Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9207-727X","authenticated-orcid":false,"given":"Dewei Jordan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3010-5247","authenticated-orcid":false,"given":"Swetha","family":"Prabhakaran","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Warrier","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9846-8776","authenticated-orcid":false,"given":"Alexander","family":"Heriot","sequence":"additional","affiliation":[{"name":"Division of Cancer Surgery Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Division of Cancer Research Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1392-2480","authenticated-orcid":false,"given":"Joseph C.","family":"Kong","sequence":"additional","affiliation":[{"name":"Division of Cancer Surgery Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Division of Cancer Research Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1992.tb05463.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-014-2069-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e31821c4b95"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0767-9"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-016-0161-2"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-017-2886-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15366"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02050815"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15464"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13281"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1457496918812219"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2004.03055.x"},{"key":"e_1_2_9_15_1","first-page":"223","article-title":"Extended low Hartmann operation with Total Mesorectal excision\u2010optimal surgical treatment in stage IV mid and upper rectal cancer","volume":"10","author":"Timofeiov S","year":"2014","journal-title":"J. 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