Major Scope

  •  Colon and Rectal Surgery
  •  General Surgery
  •  Gynecologic Oncology
  •  Plastic Surgery
  •  Neurological Surgery
  •  Orthopaedic Surgery
  •  Orthopaedic Surgery of the Spine
  •  Neonatal Surgery
  •  Prenatal Surgery
  •  Trauma Surgery
  •  Surgical Intensivists, Specializing In Critical Care Patients
  •  Thoracic Surgery
  •  Congenital Cardiac Surgery
  •  Thoracic Surgery-Integrated
  •  Vascular Surgery

Abstract

Citation: Clin Surg. 2016;1(1):1247.Research Article | Open Access

Hartmann's Procedure versus Primary Anastomosis for Emergency Left Colectomy: A Retrospective Cohort Study

Hugo Teixeira Farinha, Fabian Grass, Emmanuel Melloul, Dieter Hahnloser, Nicolas Demartines and Martin Hübner

Department of Visceral Surgery, University Hospital of Lausanne (CHUV), Switzerland

*Correspondance to: Martin Hubner 

 PDF  Full Text DOI: 10.25107/2474-1647.1247

Abstract

Background: The ideal surgical strategy for left emergency colectomy remains controversial and is decided on a case-by-case basis. The aim of this study was to analyze our current practice and outcomes to define a standardized approach.Method: This retrospective review included all consecutive patients who underwent left emergency colectomy between July 2006 and June 2013. Demographics, surgical data, and postoperative outcomes were compared between patients with primary anastomosis (PA group) and those having Hartmann’s procedure (HP group).Results: Final analysis included 148 patients (89 men, median age 76 (range 22-95) years). Patients with HP (n=73) were older and had higher ASA score (p< 0.001) and Charlson index (p< 0.001) than patients with PA (n=75). Indications were similar between the comparative groups, but noradrenalin requirements and Hinchey III/IV status were more frequent in the HP group. Patients with HP had higher in-hospital mortality (15 vs. 4%, p=0.020), overall (78 vs. 56%, p=0.005) and severe complications (29 vs. 17%, p=0.033). Anastomotic leak rate was 8% (n=6) after PA. Only 18 patients (25%) of the HP group proceeded to stoma take-down, while all patients with PA were stoma-free 12 months after hospital discharge.Conclusion: Emergent left-sided colectomy remains associated with high postoperative morbimortality. Patient’s condition and intraoperative findings appear to guide surgical decision-making. Hartmann’s procedure does not prevent adverse outcomes and entails a high permanent ostomy rate.

Keywords

Cite the article

Farinha HT, Grass F, Melloul E, Hahnloser D, Demartines N, Hubner M. Hartmann's Procedure versus Primary Anastomosis for Emergency Left Colectomy: A Retrospective Cohort Study. Clin Surg. 2016; 1: 1247.

Journal Basic Info

  • Impact Factor: 2.395**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
  • NLM ID: 101702548

Search Our Journal

Journal Indexed In

Articles in PubMed

Sildenafil Transiently Delays Early Alveolar Bone Healing of Tooth Extraction Sockets
 PubMed  PMC  PDF  Full Text
Automated Sagittal Craniosynostosis Classification from CT Images Using Transfer Learning
 PubMed  PMC  PDF  Full Text
View More...

Articles with Grants

Correlation between Characteristics of Lymph Node Metastasis and Prognosis of N1-N2 Stage Non-small Cell Lung Cancer
 Abstract  PDF  Full Text
Laparoscopic Hepatectomy Reduces the Incidence of Postoperative Hypoalbuminemia: A Propensity Score Matching Analysis with Open Hepatectomy
 Abstract  PDF  Full Text
View More...