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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
PubMed
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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:

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  • 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.