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Hartmann's procedure: an appraisal
R J Whiston1, N C Armitage, D Wilcox
1Department of Surgery, University Hospital, Nottingham.
Insights
Hartmann's procedure, an emergency operation for many, resulted in high mortality (22%) and morbidity (56%). Restoration of intestinal continuity was successful in 30 patients, though postoperative complications remained a concern.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes
- Patient Demographics
Background:
- Hartmann's procedure is a significant surgical intervention.
- High rates of emergency procedures are noted.
- Understanding outcomes is crucial for patient care.
Purpose of the Study:
- To evaluate the outcomes of Hartmann's procedure.
- To assess mortality and morbidity associated with the procedure.
- To analyze factors influencing successful reversal.
Main Methods:
- Retrospective review of 97 patients undergoing Hartmann's procedure.
- Data collected between 1981 and 1986.
- Analysis of complication types and reversal rates.
Main Results:
- Overall mortality was 22% and morbidity was 56%.
- Infective and cardiovascular issues were the most common complications (77%).
- 30 patients had successful restoration of intestinal continuity, primarily those with emergency benign disease.
Conclusions:
- Hartmann's procedure is associated with significant mortality and morbidity.
- Patient age and comorbidities contribute to complications.
- While reversal is possible, postoperative morbidity persists.
Abstract:
Ninety-seven patients underwent Hartmann's procedure between 1981 and 1986 at the University Hospital, Nottingham. Sixty-one (63%) required this operation as an emergency procedure. There was an overall mortality of 22% and the morbidity rate was 56%. Infective and cardiovascular problems accounted for 77% of all complications encountered reflecting the age and underlying condition of the patients requiring this procedure. Thirty patients had successful restoration of intestinal continuity, the majority of these having their original procedure performed as an emergency for benign disease. There were no immediate postoperative deaths from reanastomosis and few short- or long-term anastomotic problems, however there was again considerable postoperative morbidity.