Decision-Making Factors and Frequency of Intraoperative Changes to Hartmann’s Procedure in Rectal Cancer Surgery

Rectal cancer patients who underwent Hartmann’s procedure were significantly older, had more comorbidities, and were more likely to have the procedure preoperatively due to comorbidities or oncological reasons. In 23% of cases, the decision to perform Hartmann’s procedure was made intraoperatively, mainly due to anastomotic difficulties and oncological reasons. Factors increasing the risk of intraoperative anastomotic difficulties included mid-rectal cancer, male gender, and age. The study highlights the need to consider Hartmann’s procedure preoperatively, especially in older and frail patients with mid-rectal cancer and/or male gender.