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[Morbi-mortality after Hartmann procedure for peritonitis complicating sigmoid diverticulitis. A retrospective analysis of 85 cases].
Ann Chir 2005 Jul-Aug; 130(6-7):391-9AC

Abstract

INTRODUCTION

Hartmann's procedure (HP) is a simple operation, which can be performed by all the surgeons. However, it remains criticized (high morbimortality, low rate of intestinal continuity restoration). The aim of this study was to analyse natural history of HP and intestinal continuity restoration for sigmoid diverticulitis, and to assess risk factors for mortality, morbidity and absence of intestinal continuity restoration.

PATIENTS AND METHODS

In three centers, from 1992 to 2002, 85 patients underwent HP. A retrospective analysis was performed on mortality, early and late morbidity of HP and intestinal continuity restoration.

RESULTS

22% of patients (mean age, 68 years) presented comorbidity, 17% of them, an altered immunity, and 3 or 4 Hinchey score for 64%. ASA score was > or =3 in 49% of the cases. Mean AFC and Mannheim scores were 2 and 21 respectively. Mortality rate was 14% and in-hospital morbidity, 50%. Main complications were: cardiorespiratory (18%), wound abcess (14%) and stomal (6%). No rectal stump fistula was noted. Mean hospital stay was 19+/-13 days. Late morbidity rate was 29%, mainly due to stomal complications (12%) and small bowel obstruction (7%). Intestinal continuity restoration was done in 77% of the cases, followed by only 1 fistula. Mortality rate for intestinal continuity restoration was 0% and morbidity was 13%. Mean hospital stay was 10+/-3 days. Age >75 years, ASA score > or =3 and comorbidity were risk factors for morbidity and mortality and for absence of intestinal continuity restoration.

CONCLUSIONS

HP is associated with a high morbidity and mortality rates. Intestinal continuity restoration rate was high in this series. HP is a simple operation in high-risk patients with advanced peritonitis. This study allows to precise natural history of HP. Knowledge of this history is crucial for choosing the best operation (between HP and anastomosis) for patient with peritonitis complications sigmoid diverticuitis.

Authors+Show Affiliations

Services de chirurgie viscérale et digestive, CHU, université de Picardie, hôpital d'Amiens, Amiens Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

15982629

Citation

Dumont, F, et al. "[Morbi-mortality After Hartmann Procedure for Peritonitis Complicating Sigmoid Diverticulitis. a Retrospective Analysis of 85 Cases]." Annales De Chirurgie, vol. 130, no. 6-7, 2005, pp. 391-9.
Dumont F, Vibert E, Duval H, et al. [Morbi-mortality after Hartmann procedure for peritonitis complicating sigmoid diverticulitis. A retrospective analysis of 85 cases]. Ann Chir. 2005;130(6-7):391-9.
Dumont, F., Vibert, E., Duval, H., Manaouil, D., Sredic, A., Alfahel, N., ... Regimbeau, J. M. (2005). [Morbi-mortality after Hartmann procedure for peritonitis complicating sigmoid diverticulitis. A retrospective analysis of 85 cases]. Annales De Chirurgie, 130(6-7), pp. 391-9.
Dumont F, et al. [Morbi-mortality After Hartmann Procedure for Peritonitis Complicating Sigmoid Diverticulitis. a Retrospective Analysis of 85 Cases]. Ann Chir. 2005;130(6-7):391-9. PubMed PMID: 15982629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Morbi-mortality after Hartmann procedure for peritonitis complicating sigmoid diverticulitis. A retrospective analysis of 85 cases]. AU - Dumont,F, AU - Vibert,E, AU - Duval,H, AU - Manaouil,D, AU - Sredic,A, AU - Alfahel,N, AU - Mauvais,F, AU - De Fresnoy,H, AU - Rudant,J, AU - Katsahian,S, AU - Riboulot,M, AU - Galy,C, AU - Verhaeghe,P, AU - Dupont,H, AU - Regimbeau,J-M, PY - 2004/11/15/received PY - 2005/05/30/accepted PY - 2005/6/29/pubmed PY - 2005/9/27/medline PY - 2005/6/29/entrez SP - 391 EP - 9 JF - Annales de chirurgie JO - Ann Chir VL - 130 IS - 6-7 N2 - INTRODUCTION: Hartmann's procedure (HP) is a simple operation, which can be performed by all the surgeons. However, it remains criticized (high morbimortality, low rate of intestinal continuity restoration). The aim of this study was to analyse natural history of HP and intestinal continuity restoration for sigmoid diverticulitis, and to assess risk factors for mortality, morbidity and absence of intestinal continuity restoration. PATIENTS AND METHODS: In three centers, from 1992 to 2002, 85 patients underwent HP. A retrospective analysis was performed on mortality, early and late morbidity of HP and intestinal continuity restoration. RESULTS: 22% of patients (mean age, 68 years) presented comorbidity, 17% of them, an altered immunity, and 3 or 4 Hinchey score for 64%. ASA score was > or =3 in 49% of the cases. Mean AFC and Mannheim scores were 2 and 21 respectively. Mortality rate was 14% and in-hospital morbidity, 50%. Main complications were: cardiorespiratory (18%), wound abcess (14%) and stomal (6%). No rectal stump fistula was noted. Mean hospital stay was 19+/-13 days. Late morbidity rate was 29%, mainly due to stomal complications (12%) and small bowel obstruction (7%). Intestinal continuity restoration was done in 77% of the cases, followed by only 1 fistula. Mortality rate for intestinal continuity restoration was 0% and morbidity was 13%. Mean hospital stay was 10+/-3 days. Age >75 years, ASA score > or =3 and comorbidity were risk factors for morbidity and mortality and for absence of intestinal continuity restoration. CONCLUSIONS: HP is associated with a high morbidity and mortality rates. Intestinal continuity restoration rate was high in this series. HP is a simple operation in high-risk patients with advanced peritonitis. This study allows to precise natural history of HP. Knowledge of this history is crucial for choosing the best operation (between HP and anastomosis) for patient with peritonitis complications sigmoid diverticuitis. SN - 0003-3944 UR - https://www.unboundmedicine.com/medline/citation/15982629/[Morbi_mortality_after_Hartmann_procedure_for_peritonitis_complicating_sigmoid_diverticulitis__A_retrospective_analysis_of_85_cases]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-3944(05)00137-9 DB - PRIME DP - Unbound Medicine ER -