Titre
Hartmann's Procedure versus Primary Anastomosis for Emergency Left Colectomy: A Retrospective Cohort Study
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Teixeira Farinha, Hugo
Auteure/Auteur
Grass, Fabian
Auteure/Auteur
Melloul, Emmanuel
Auteure/Auteur
Hahnloser, Dieter
Auteure/Auteur
Demartines, Nicolas
Auteure/Auteur
Hübner, Martin
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2474-1647
Statut éditorial
Publié
Date de publication
2016-12-13
Volume
1
Numéro
1
Première page
1247
Peer-reviewed
Oui
Langue
anglais
Résumé
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.
PID Serval
serval:BIB_E98FBB50D114
Date de création
2023-10-27T20:13:39.838Z
Date de création dans IRIS
2025-05-21T05:48:31Z
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Nom
hartmann39s-procedure-versus-primary-anastomosis-for-emergency-left-colectomy-a-retrospective-cohort-study-2692.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by-nc/4.0
Taille
4.47 MB
Format
Adobe PDF
PID Serval
serval:BIB_E98FBB50D114.P001
URN
urn:nbn:ch:serval-BIB_E98FBB50D1146
Somme de contrôle
(MD5):17cdfb0360fb2f8fbbc93a46aef535aa