To investigate specific patient-related factors predicting the selection of Hartmann's procedure (HP) in rectal cancer patients and assess the frequency and reasons for intraoperative changes from anterior resection (AR) to HP.
Key Findings:
HP was performed in 275 patients (24%) of the study cohort.
AR and APR were performed in 491 (43%) and 375 (33%) patients, respectively.
Patients undergoing HP were significantly older and had a higher prevalence of cardiovascular disease and diabetes compared to AR and APR groups.
Intraoperative changes from AR to HP occurred in 19 patients, indicating variability in surgical decision-making.
Interpretation:
The findings suggest that patient age and comorbidities influence the decision to perform HP, highlighting the need for careful intraoperative assessment to improve surgical outcomes.
Limitations:
Retrospective design may introduce selection bias, potentially affecting the generalizability of the findings.
Data on intraoperative decision-making may be incomplete due to missing medical records, which could impact the analysis.
Conclusion:
HP remains a viable option for certain rectal cancer patients, particularly those with significant comorbidities, but the decision often relies on thorough intraoperative evaluations.
