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Pelvic sepsis after extended Hartmann's procedure
1Department of Surgery L, University Hospital of Aarhus, Tage Hansensgade 2, 8000 Aarhus C, Denmark. anders_tottrup@hotmail.com
Diseases of the Colon and Rectum
|February 17, 2005
Summary
An extended Hartmann's procedure for rectal resection can lead to pelvic sepsis, especially when the rectum is transected less than 2 cm above the pelvic floor. Male gender and poor circulation are additional risk factors.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes
- Pelvic Sepsis
Background:
- The extended Hartmann's procedure is an option for rectal resections, aiming to prevent anastomotic, perineal, and functional issues.
- However, the risk of pelvic sepsis following this procedure requires further investigation.
Purpose of the Study:
- To investigate the incidence of pelvic sepsis after an extended Hartmann's procedure for rectal resection.
- To identify potential risk factors associated with pelvic sepsis in these patients.
Main Methods:
- A retrospective review of medical records was conducted for 163 patients who underwent rectal resection with colostomy and rectal remnant closure.
- Data on pelvic sepsis and potential risk factors were extracted from patient records.
Main Results:
- Pelvic sepsis occurred in 18.6% of patients (31 out of 163).
- Transection of the rectum less than 2 cm above the pelvic floor was associated with a significantly higher risk of pelvic abscess (32.9% vs. 7.8%, P = 0.0001).
- Male gender and presence of absent foot pulses were identified as other risk factors. Many pelvic abscesses had prolonged healing times.
Conclusions:
- Consideration of alternative surgical approaches is recommended when the rectal transection level is less than 2 cm above the pelvic floor, particularly in male patients.
- The findings highlight the importance of surgical technique and patient factors in managing pelvic sepsis risk.