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Resection and Primary Anastomosis versus Hartmann’s Operation in Emergency Surgery for Acute Mechanical Obstruction due to Left-Sided Colorectal Cancer

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Abstract

In cases of obstructed left-sided colorectal cancer, Hartmann’s operation or resection and primary anastomosis are alternative surgical methods. Our aim was to compare the outcomes of the two different surgical techniques performed in emergency cases. Obstructed left-sided colorectal cancer patients operated on between 2011 and 2018 were evaluated. Demographics, preoperative laboratory results, American Society of Anesthesiologists scores, types of operative procedures, intraoperative findings, and surgical outcomes were recorded and analyzed. p < 0.05 was accepted as statistically significant. Among the 68 patients included, 46 (67.6%) were men, and 20 (32.4%) were women with a mean age of 64 SD13.9 (range: 35–89). Hartmann’s operation was performed in 50 (73.5%) patients, whereas resection and primary anastomosis without the creation of a proximal ostomy were carried out in 18 (26.5%) patients. There were no differences between the two groups in comparison to the American Society of Anesthesiologists scores and the laboratory results except creatinine (p > 0.05). Creatinine levels were higher in the Hartmann’s operation group (p < 0.05). Tumors were found to be more commonly located in the descending colon in the resection and primary anastomosis group and in the sigmoid colon in the Hartmann’s operation group (p < 0.05). Postoperative complications, length of hospital stay, and mortality rates were similar (p > 0.05). Since there were no significant differences between the use of either Hartmann’s operation or primary anastomosis regarding postoperative complications and mortality rates, primary anastomosis may be preferred to Hartmann’s operation to avoid the need for a second intervention in emergency surgical cases of obstructed left-sided colorectal cancer.

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All authors declare that no source of funding exists, and that they have no direct or indirect commercial financial incentive associated with publishing this article.

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Authors and Affiliations

  1. Department of General Surgery, Faculty of Medicine, İstanbul Medeniyet University Göztepe Training & Research Hospital, Dr. Erkin Street, Göztepe, Kadıköy, 34722, İstanbul, Turkey

    Ozgur Ekinci, Aman Gapbarov, Cem Ilgin Erol, Damla Beyazadam, Tunc Eren & Orhan Alimoglu

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  1. Ozgur Ekinci
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  2. Aman Gapbarov
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  3. Cem Ilgin Erol
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  4. Damla Beyazadam
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Contributions

Ozgur EKINCI: Protocol/project development, data collection or management, data analysis, manuscript writing/editing, critical revision, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Aman GAPBAROV: Protocol development, literature search, collection, data analysis, manuscript writing, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Cem Ilgin EROL: Data collection, data analysis, manuscript writing, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Damla BEYAZADAM: Data collection or management, data analysis, manuscript writing, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Tunc EREN: Project development, literature search, collection, data analysis, manuscript writing/editing, critical revision, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Orhan ALIMOGLU: Protocol development, data analysis, manuscript editing, critical revision, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Tunc Eren.

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The authors declare that they have no conflict of interest.

Ethical Standards Statement

Approval for this study was obtained from the Institutional Review Board (IRB) Ethics Committee (IRB number: 2018/0176), and signed informed consent forms were obtained from all patients. All procedures performed were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study was presented as an oral presentation at the 2nd Annual Albanian Congress of Trauma and Emergency Surgery in Ohrid, Macedonia between November 8th–10th, 2018.

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Ekinci, O., Gapbarov, A., Erol, C.I. et al. Resection and Primary Anastomosis versus Hartmann’s Operation in Emergency Surgery for Acute Mechanical Obstruction due to Left-Sided Colorectal Cancer. Indian J Surg 83, 428–434 (2021). https://doi.org/10.1007/s12262-020-02387-5

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