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Related Experiment Videos

[The Hartmann procedure: current situation in Spain].

Antonio Codina-Cazador1, Ramon Farres, Francisco Olivet

  • 1Servicio de Cirugía General y Digestiva, Hospital Universitario Dr. J. Trueta, Girona, Spain. cirurgia@htrueta.scs.es

Cirugia Espanola
|January 20, 2006
PubMed
Summary

The Hartmann procedure in emergency colon surgery is often performed due to patient factors like high risk and abdominal conditions, rather than surgeon preference. Over half of patients could have had anastomosis, highlighting a need to re-evaluate indications.

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Emergency Medicine

Context:

  • The Hartmann procedure is a controversial technique in emergency colon surgery.
  • Therapeutic alternatives are debated.
  • This study analyzes the indications and outcomes of the Hartmann procedure.

Purpose:

  • To analyze when, why, and in whom the Hartmann procedure is performed in emergency colon surgery.
  • To evaluate the results of the Hartmann procedure.
  • To assess if alternative procedures like anastomosis were feasible.

Summary:

  • A descriptive analysis of 105 emergency Hartmann procedures was conducted.
  • Patient factors (age, comorbidities, presenting symptoms, ASA score) and surgical findings (occlusion, peritonitis, perforation) were analyzed.

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  • Morbidity was 51% and mortality was 11%; 50.5% of patients could have potentially undergone anastomosis.

    • Impact:

    • The Hartmann procedure is primarily indicated by patient-related factors (risk, general and local abdominal status).
    • Surgeon-related factors also influence the decision.
    • Findings suggest a potential for increased use of primary anastomosis in selected cases.