Address of Corresponding Author

Dig Surg 2005;22:419-425 (DOI: 10.1159/000091444)

  Key Words

• Hartmann procedure
• Diverticulitis
• POSSUM
• p-POSSUM

  Abstract

Background: Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients who underwent secondary restoration after a Hartmann procedure for complicated diverticulitis were studied and the factors leading to complications and mortality were identified. Patients and Methods: Of 91 patients, in a consecutive 12-year period, whose primary operation was a Hartmann procedure, 72 survived longer than 3 months after discharge. Sixty-five underwent an attempted reversal of the Hartmann procedure. The POSSUM scores were calculated in all patients as well as the morbidity and mortality rates. Results: In 63 (96.9%) patients the bowel continuity could be restored with a morbidity of 38.5% and a mortality of 3.1%. The POSSUM and p-POSSUM scores adequately predicted the mortality in this series. Conclusion: This series shows that when surgical treatment for complicated diverticular disease of the sigmoid colon is necessary, the Hartmann procedure is still a valid indication. In a high percentage of patients the Hartmann procedure could be restored with a low mortality.

Copyright © 2005 S. Karger AG, Basel

  Author Contacts

J.L.T. Oomen, MD
Zaans Medisch Centrum, Koningin Julianaplein 58
Postbus 210
NL-1500 EE Zaandam (The Netherlands)
Tel. +31 75 650 2319, Fax +31 75 650 2123, E-Mail j.oomen4@chello.nl

  Article Information

Received: February 28, 2005
Accepted: August 15, 2005
Published online: February 10, 2006
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 5, Number of References : 46