14 October 2020


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:

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.

Our researchers are working day in day out to find effective treatments to save and improve lives.

This research is only possible due to the generosity of our donors.

Please donate.
Let's end bowel cancer & bowel disease.