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The Hartmann procedure

F C Bakker, H F Hoitsma, G Den Otter

    The British Journal of Surgery
    |October 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    The Hartmann operation, a surgical procedure, resulted in a high postoperative mortality rate of 37.3% and significant complications. Reversing the Hartmann operation to restore colorectal continuity was successful in a minority of patients.

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    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:

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    • 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.