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The Hartmann procedure.

B Marien

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |January 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    The Hartmann procedure, involving colonic resection and end-colostomy, was revisited for high-risk patients. While complications were noted, restoring bowel continuity in select cases proved safe.

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    Area of Science:

    • Colorectal Surgery
    • Surgical Oncology
    • Gastroenterology

    Background:

    • The Hartmann procedure was initially described for rectosigmoid cancer in high-risk patients.
    • Interest in the Hartmann procedure was renewed at a Montreal hospital between 1972 and 1984.
    • The primary indications shifted towards diverticulitis, with cancer becoming a secondary concern.

    Purpose of the Study:

    • To review the experience with the Hartmann procedure in a specific patient cohort.
    • To analyze the indications, outcomes, and complications associated with the Hartmann procedure.

    Main Methods:

    • Retrospective review of 64 patients who underwent the Hartmann procedure.
    • Analysis of patient demographics, indications for surgery, operative details, and postoperative outcomes.

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  • Evaluation of mortality rates, complication rates, and the success of subsequent bowel continuity restoration.

    • Main Results:

    • The average patient age was 80 years, with common indications including obstruction, perforation, and abscesses.
    • The overall mortality rate was 17%, with an 8% 30-day mortality. The complication rate was 35%.
    • Restoration of bowel continuity was performed in 28 patients 2-3 months postoperatively, with no associated deaths.

    Conclusions:

    • The Hartmann procedure remains a viable option for selected high-risk patients, particularly for diverticulitis.
    • While the procedure carries significant morbidity and mortality, staged reversal is feasible and safe in carefully selected cases.