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[Hartmann's procedure. Institutional experience with 92 consecutive cases]
A González Ojeda1, O Durán Ramos, J Avalos González
1Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades del Centro Médico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México. abigail@vianet.com.mx
Revista De Gastroenterologia De Mexico
|October 26, 1999
Summary
Hartmann's procedure is a viable option for emergency left colonic complications. While morbidity and mortality are linked to patient condition, reestablishing bowel continuity had a low rate in this study.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Hartmann's procedure, described in 1923, is a common surgical treatment for acute left colonic issues.
- It is particularly utilized when preoperative bowel preparation is not feasible or when there's a high risk of anastomotic complications.
Purpose of the Study:
- To analyze the outcomes of Hartmann's operation in treating consecutive patients.
- The study aimed to assess surgical indications, intraoperative findings, and post-operative morbidity and mortality.
Main Methods:
- A prospective, non-randomized, and longitudinal study design was employed.
- Data were collected from patients undergoing Hartmann's procedure between March 1995 and September 1998.
Main Results:
- Ninety-two patients underwent the procedure, with 60% over 65 years old and 91% requiring emergency surgery.
- The study reported a 34% morbidity rate and a 19% mortality rate.
- Bowel continuity was restored in 32% of cases during the follow-up period, with no associated fatalities.
Conclusions:
- Hartmann's procedure is a suitable choice for non-elective surgical treatment of complicated rectosigmoid pathology.
- Patient's preoperative sepsis and overall condition significantly influence the operation's morbidity and mortality.
- The low rate of bowel continuity reestablishment may be attributed to the study's limited follow-up duration.