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[Hartmann's procedure in emergency surgery of the colorectum]
C Coco1, G Roncolini, P Granone
1Istituto Semeiotica Chirurgica, Università Cattolica del Sacro Cuore di Roma.
Insights
The Hartmann procedure is a suitable emergency surgery for left colon issues, particularly perforative diverticulitis. This surgical approach offers a low mortality rate and is well-tolerated by high-risk patients.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Emergency Medicine
Background:
- The Hartmann procedure is a surgical option for left colon emergencies.
- Indications include perforative diverticulitis and colorectal cancer.
Purpose of the Study:
- To evaluate the outcomes and safety of the Hartmann procedure.
- To assess its suitability for emergency left colon operations.
Main Methods:
- Retrospective analysis of 28 patients undergoing the Hartmann procedure.
- Data collected on patient demographics, indications, and outcomes.
Main Results:
- Perforative diverticulitis (14) and carcinoma (11) were primary indications.
- 71% of procedures were emergencies.
- Post-operative mortality was 3.5%, and morbidity was 10.7%.
- Successful colonic continuity restoration in 14 patients with no mortality or morbidity.
Conclusions:
- The Hartmann procedure is a safe and effective option for left colon emergencies.
- It is well-tolerated, especially by poor-risk patients.
- Considered a suitable primary operation for emergency left colon conditions.
Abstract:
The authors report their experience with Hartmann procedure. 28 patients were treated: 21 males and 7 females. The mean age was 58 years. Perforative diverticulitis was the commonest indication (14 patients), followed by carcinoma (11 patients). Miscellaneous causes accounted for 3 patients. This procedure was primarily performed as an emergency operation (71%). One patient died post-operatively (3.5%); post-operative morbidity was 10.7%. A second operation was not planned if the first operation had been performed for palliation of metastatic or locally advanced cancer (7 patients). Restoration of colonic continuity was achieved successfully in 14 patients with no mortality and morbidity. According to their experience, authors believe Hartmann procedure to be the most suitable operation facing a left colon emergency. It is usually easy to perform and well tolerated by poor risk patients.