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Published on: June 5, 2019
[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
Background:
Since it's description in 1923, Hartmann's procedure is widely used for the surgical treatment of acute left colonic complications when preoperative bowel lavage is not feasible and/or there is high risk of anastomotic dehiscence.
Objective:
Analyze the results of Hartmann's operation in the surgical treatment of consecutive patients at a single institution during a 30-month interval.
Type Of Study:
Prospective, non-randomized and longitudinal study.
Material And Methods:
Patients treated with the Hartmann procedure between March 1995 and September 1998. Surgical indication, intraoperative findings, morbidity and mortality were analyzed as well as the rate of reestablishment of bowel continuity and it's morbimortality.
Results:
Ninety-two patients underwent a Hartmann procedure. The mean patient's age was 60 +/- 25 years (range of 21 to 88 years) and 60% were older than 65 years. An emergency operation was carried out in 91% of the cases. Most of the patients had intra-abdominal sepsis (56%) and benign colonic process (83%). The morbidity rate was 34% and mortality rate 19. During follow-up the bowel continuity was reestablished in 32% of the cases without fatalities.
Conclusions:
Hartmann's procedure is a good option for non-elective surgical treatment complicated rectosigmoid pathology. The morbidity and mortality of the operation are highly dependent on the degree of preoperative sepsis and the patient's preexisting condition. The rate of reestablishment of bowel continuity was low probably because of short follow-up.
