For some patients with rectal cancer, standard treatment is not an option. This is because they are either too frail to undergo surgery to remove part of the rectum and reconnect it, or because it’s simply not possible to do so.
In these cases, surgeons have two options – an operation called Hartmann’s procedure, or, intersphincteric abdominoperineal excision (IAPE). Unfortunately, very little evidence existed to guide surgeons on which of these operations was safer and had the lower complication rate, so it was largely a decision for individual surgeons to make.
Definitively answering questions like this is what Bowel Research UK exists to do. We fund research that ensures patients get the safest, most effective treatment for bowel disease. That’s why we funded the HiP study – the largest-ever comparison of these two methods for caring for frail patients with rectal cancer.
HiP was born on a cold November day 7 years ago, where patients and surgeons came together to address the top research priorities in bowel disease. That session led to the creation of the HiP study and a whole programme of research & prioritisation, where patients & medical professionals worked hand in hand. Now it has led to the publication of yet more important research, definitively answering a question for patient benefit.
The results of the project found no significant variation in complication rates or quality of life between Hartmann’s and IAPE, although there were some minor variations between the two.
Dale Vimalachandran, who led the research, said: “HiP is the largest ever prospective study of this patient group and provided valuable information on both the complication rate and quality of life associated with each procedure. From a patient perspective, HiP provides reassurances that both procedures are safe and importantly provides further information regarding the safety and appropriateness of cancer surgery in an ageing population.”
Leading surgeons from around the world also welcomed the findings on social media:
A good and balanced discussion of pros and cons for Hartmans proc. versus intersphincteric resection in frail pt with rectal cancer. Largest study to date with very valuable data on 179 patients with 90 days Follow-up. @cssdenmark @escp_tweets @BJSurgery https://t.co/qn5OOM7GDh
— ismail gögenur (@IsmailGogenur) October 6, 2020
Thanks @SWexner for mention – @dalevim the driving force behind #HiP and it’s successful completion. Just doing the study made me re-evaluate my own practice. Had always favoured iAPE but found that low Hartmann’s also had its merits. Intriguing @ColorectalDis
— Nicola Fearnhead (@cam_colorectal) October 4, 2020
A most memorable day and the start of an amazing journey for me, lots of new friends, mentors, collaborations and a rewarding career that has surpassed all my expectations ! #whydoresearch #collaboration @EYCN_ACP @Dukes_Club https://t.co/HO1KeSaZGb
— Dale Vimalachandran (@dalevim) October 3, 2020
We are delighted to have once again played a part in delivering unique research that has addressed previously unanswered questions. Both patients & medical professionals will benefit from these findings in the future.
The full findings of the HiP study can be found in Colorectal Disease Journal.