Hartmann’s procedure and its outcome - An analysis of 78 consecutive cases

Authors

  • Sanjay Dalmia

DOI:

https://doi.org/10.3823/1658

Keywords:

Hartmann’s, outcome, reversal, complications

Abstract

Background

To analyse the outcome of patients who had Hartmanns procedure (HP) performed in a single institution.

Methods and findings

We retrospectively analysed 78 consecutive patients who had HP performed in our Hospital from 1st January 2010 to 31st December 2013 over a four year period. We analysed age, sex, indications, emergency or elective stoma formation, complications, reversal rate and complications of reversal. Mean age of these 78 patients with HP was 69 years (Range 34-92 years). Thirty five patients were females and 43 were males. In 61 (76.2%) patients HP was done as an emergency and in 17(23.8%) it was done on an elective basis. Out of these 78 patients, 40 (47.2%) had complicated diverticular disease and 25 (34.7%) had locally advanced or obstructed rectosigmoid carcinoma. Out of 78 patients who had HP, 12 died in the postoperative period. Nine (12.5%) patients developed parastomal hernia. One each had ischaemia, prolapse and stenosis. Only 18 (23.07%) patients had their Hartmann’s reversal (HR) done, all of these were by open method. Commonest complication following Hartmann’s reversal was hernia at the stoma site which was seen in three patients.

Conclusion

HP has a high mortality due to the primary disease process. It has a high rate of long term complications like parastomal hernia. In our series only 23.07 % patients had their Hartmann’s reversed. 

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Published

2015-03-25

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Section

General Surgery