Hartmann procedure revisited

Objective: To assess the complications and results of Hartmann's procedure and secondary restoration of continuity for left-sided colonic disease. Design: Retrospective study Setting: University hospitals, Northern ireland. Subjects: 72 Patients who required a Hartmann's procedure over a 13 year period (1985-1998). Intervention: Of these 45 (63%) were done as emergencies and 27 (38%) as elective procedures. The indications for an emergency procedure were obstruction and perforation. Main outcome measures: Mortality, morbidity, reversal of stoma rate. Results: The overall postoperative mortality was 7/72 (10%), with no significant difference between the emergency (4/45, 9%) and the elective (3/27, 11%) groups. Postoperative complications occurred in 31 patients (43%), and 8 developed wound infections (11%). Of the 43 surviving patients who where deemed suitable for re-establishment of continuity, 30 (70%) have had it done. There were no postoperative deaths or anastomotic dehiscences after the restoration of continuity. Conclusion: Hartmann's procedure remains a safe and suitable option in patients with left sided colonic emergencies.