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Emergency surgery for complicated diverticular disease. A five-year experience
A R Berry1, W H Turner, N J Mortensen
1Department of Surgery, John Radcliffe Hospital, Oxford, United Kingdom.
Diseases of the Colon and Rectum
|October 1, 1989
Summary
Complications from diverticular disease surgery are common, with the Hartmann procedure showing high mortality and complication rates in this retrospective study. Meticulous surgical technique is crucial for improving outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Medicine
Background:
- Diverticular disease is a common condition requiring surgical intervention.
- Complications such as perforation, abscess, and obstruction necessitate surgical management.
- The Hartmann procedure has gained popularity for treating complicated diverticular disease.
Purpose of the Study:
- To retrospectively analyze surgical complications of diverticular disease.
- To evaluate the outcomes of the Hartmann procedure compared to other surgical interventions.
- To identify factors influencing patient outcomes and mortality.
Main Methods:
- Retrospective review of 93 patients undergoing surgery for diverticular disease over five years.
- Categorization of complications including free perforation, inflammation, abscess, and obstruction.
- Comparison of outcomes between patients who underwent the Hartmann procedure and those who had other operations.
Main Results:
- Overall 30-day mortality was 10.8%.
- Patients undergoing the Hartmann procedure had a significantly higher mortality rate (28%) and major complication incidence (69%).
- Seventy-three percent of patients presented with signs of severe sepsis.
Conclusions:
- The Hartmann procedure is associated with poor outcomes, particularly in high-risk patients.
- Despite high complication rates, the popularity of the Hartmann procedure is unlikely to decrease without prospective data.
- Emphasis on meticulous surgical technique is essential for improving results in diverticular disease surgery.