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Surgical results of Hartmann procedure in emergency cases with left-sided colorectal cancer
Onder Altin1, Selcuk Kaya1, Ramazan Sari1
1Department of General Surgery, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
Objective:
We aimed to define indication of Hartmann procedure (HP) under emergency conditions, analyze, and present in which cases this procedure should be used.
Methods:
The patients who underwent emergency surgery for colorectal cancer were analyzed. Rates of mortality, overall, and disease-free survival of the patients were evaluated. The colostomy closure rate, operative mortality, and surgical complications of the secondary operation performed after the HP were also assessed.
Results:
Fifty-seven patients who underwent HP were included in the study. The indications were obstruction (n = 37) or perforation (n = 20). The post-operative mortality and morbidity rates were 21.1% and 63.2%, respectively. The 1-, 3-, and 5-year survival rates for all patients were 54%, 49%, and 45%.
Conclusion:
HP can be a life-saving procedure in cases of high risk, emergency colorectal disease. Surgeons create a temporary stoma as a part of this procedure that is generally closed with a second operation. However, it is not possible to close the stoma in some cases, and the potential physical and emotional issues related to the stoma should be a part of the surgeon's considerations.
