The Hartmann procedure

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• The Hartmann operation is a surgical procedure involving the creation of a colostomy and closure of the rectal stump.
• It is employed for various conditions including diverticular disease, colorectal cancer, and anastomotic leaks.

Purpose of the Study:

• To evaluate the outcomes and complications associated with the Hartmann operation.
• To assess the feasibility and success rate of reversing the Hartmann operation.

Main Methods:

• A retrospective review of 59 patients who underwent a Hartmann operation over a 10-year period.
• Analysis of postoperative mortality, complication rates, hospital stay, and rates of stoma reversal.

Main Results:

• The study included 59 patients with diverse indications for the Hartmann operation.
• A significant postoperative mortality rate of 37.3% (22 deaths) was observed.
• Common complications included wound infections/dehiscence (26 patients), colostomy necrosis/retraction (12 patients), and rectal stump leakage (3 patients).
• The mean hospital stay for survivors was 28.4 days.
• Colorectal continuity was restored in 12 patients (32.4%), with no reported difficulties during reversal.

Conclusions:

• The Hartmann operation is associated with substantial postoperative morbidity and mortality.
• Reversal of the Hartmann operation is possible but achieved in a limited proportion of patients.
• Further research into optimizing outcomes and patient selection for the Hartmann operation and its reversal is warranted.