• Ulus Travma Acil Cerrahi Derg · Jul 2023

    Analysis of factors related to the decision of Hartmann's procedure and its reversal: a single-center experience.

    • Ali Kocataş, Erkan Somuncu, Serhan Yılmaz, Osman Sibic, Mahmut Ozan Aydın, Ceren Başaran, and Yunusemre Tatlıdil.
    • Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul-Türkiye.
    • Ulus Travma Acil Cerrahi Derg. 2023 Jul 1; 29 (7): 806810806-810.

    BackgroundHartmann's procedure (HP) is commonly applied to resolve acute clinical conditions in most cases with colonic obstruction or perforation. HP and the closure of the end colostomy are associated with high morbidity-mortality rates. In our study, we aimed to report our clinical experience in HP.MethodsDemographic data and outcomes of Hartmann procedures performed between 2015 and 2023 were retrospectively reviewed.ResultsThe median age of our study was 63 (18-94) years; 65 of the patients were female, and 97 were male. Colorectal malig-nancies were the primary etiology in 50% of patients who underwent HP, with 70% presenting with obstruction and 30% with perfora-tion. Two-thirds of the patients were American Society of Anesthesiologists-2 or higher. Postoperative complications did not develop in 74.7% of patients. Our mortality rate was 33.3%. The colostomy was closed in 59 patients during an average 2-year follow-up. The median closure time was 311 (57-1319) days. A stapler was used in 89.8% of patients during the closure. A diverting ileostomy was created in only two patients. The median hospital stay was 8 (5-70) days. Post-operative complications did not develop in 25.4% of patients, while four patients died.ConclusionIn our population, HP was more commonly performed for colorectal cancer. The procedure and closure of the ostomy result in low stoma closure rates, high morbidity, and mortality rates, as well as surgical difficulties.

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