Purpose:
There are still controversial issues in left colon pathologies in the emergency setting. Hartmann’s procedure is still widely used in left colon pathologies in the emergency setting especially in the complicated cases. In the present study we aimed to discuss the efficacy of Hartmann’s procedure in left colon pathologies in the emergency setting despite the changing treatment approaches.
Patients and Methods:
Twenty cases to whom Hartmann’s procedure was performed between January 2005 and January 2007 was retrospectively analyzed in terms of demographic characteristics, symptomatology, diagnosis, ASA score, postoperative complications and mortality encountered following initial and second operations.
Results:
Most common preoperative complaint was found to be abdominal pain and preoperatively 82.6% of the patients admitted to the hospital with intestinal obstruction. 78.3% of the patients were ASA III-IV. Following the initial step of Hartmann’s procedure 52% of the patients encountered a complication. Twenty patients (87%) could be operated for the second step of the procedure. There was a 30% rate of complications in these patients. Operative mortality for both steps of the operation was found to be 17%.
Conclusion:
Hartmann’s procedure is an efficient, easy and safe method that can be preferred by the surgeons in the emergent left colon pathologies depending on the physiologic status of the patient, underlying disease process and the level of intraabdominal contamination.
Keywords: Emergent left colon pathologies, primary anastomosis, Hartmann’s procedure, complication, mortality