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30.05.2017 | Original Article | Ausgabe 5/2017 Open Access

Techniques in Coloproctology 5/2017

The importance of rectal washout for the oncological outcome after Hartmann’s procedure for rectal cancer: analysis of population-based data from the Swedish Colorectal Cancer Registry

Techniques in Coloproctology > Ausgabe 5/2017
F. Jörgren, R. Johansson, H. Arnadottir, G. Lindmark
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10151-017-1637-5) contains supplementary material, which is available to authorized users.
This paper was presented as a poster at the Annual Meeting of the European Society of Coloproctology, Barcelona, 24–26 September 2014; published in abstract form in Colorectal Dis 2014; 16(Suppl 3): p. 213.



During rectal cancer surgery the bowel may contain viable, exfoliated cancer cells, a potential source for local recurrence (LR). The amount and viability of these cells can be reduced using intraoperative rectal washout, a procedure that reduces the LR risk after anterior resection. The aim of this study was to analyse the impact of washout on oncological outcome when performed in Hartmann’s procedure (HP) for rectal cancer.


A national cohort study on data for patients registered from 1995 to 2007 in the Swedish Colorectal Cancer Registry was carried out. The final analysis included patients belonging to TNM stages I–III who had undergone R0 HP with a registered 5-year follow-up. Multivariate analysis was performed.


A total of 1188 patients were analysed (686 washout and 502 no washout). No differences were detected between the washout group and the no washout group concerning rates of LR [7% (49/686) vs. 10% (49/502); p = 0.13], distant metastasis (DM) [17% (119/686) vs. 18% (93/502); p = 0.65], and overall recurrence (OAR) [21% (145/686) vs. 24% (120/502); p = 0.29]. For both groups, the 5-year cancer-specific survival was below 50%. In multivariate analysis, washout neither decreased the risk of LR, DM, or OAR nor increased overall or the cancer-specific 5-year survival.


The oncological outcome did not improve when washout was performed in HP for rectal cancer.

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