Primary Anastomosis Versus Hartmann’s Procedure in Obstructing Colorectal Cancer: A Retrospective Cohort Study
Bibliographic record
Abstract
Introduction: The objective of this study was to analyze and compare the outcomes of two surgical techniques in the emergency management of obstructed colorectal carcinoma. Methods: This is a retrospective analysis of patients’ data from a tertiary referral university hospital. The medical records of patients who underwent emergency surgery for obstructed colorectal cancer between May 2014 and August 2019 were evaluated. The cases were divided primarily into two groups: Primary Resection and Anastomosis (PRA) and Hartmann’s Procedure (HP). The clinical characteristics, peri-operative outcomes and oncological results including early postoperative complications, morbidity and mortality (30-day, 1-year and 5-year survival) were compared between groups. Results: In this retrospective study, 110 patients with obstructing colorectal cancer undergoing emergency surgery were analyzed. Patients were divided into two groups: 65 cases of Primary Resection and Anastomosis (PRA) and 45 cases of Hartmann’s Procedure (HP). PRA patients had significantly shorter hospital stays (8.7 ± 4.1 vs. 11.2 ± 5.2 days, p = 0.02), lower complication rates (33% vs. 66%, p = 0.003), and superior survival outcomes, with a 5-year survival rate of 33.8% compared to 22.2% in the HP group (p = 0.003). Subgroup analysis revealed significant differences, including higher complication rates and repeat surgery requirements in patients with a diverting ostomy or undergoing resection without anastomosis. Conclusion: PRA demonstrated favorable perioperative and long-term outcomes compared to HP in the emergency management of obstructing colorectal cancer. These findings highlight the potential benefits of avoiding permanent stoma formation when appropriate patient selection criteria are met.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".