The Hartmann procedure. Extended indications in severe intra-abdominal infection.
During a three-year period, 30 patients had emergency Hartmann procedures for diverticular disease (N = 12), carcinoma (N = 6), trauma (N = 3), and miscellaneous causes (N = 9). Two patients died postoperatively (6.7 percent) and wound infection developed in 60 percent of the patients. Planned relaparotomies for severe intra-abdominal infection were performed in ten patients (an average of 2.5 procedures per patient) with no mortality. In five cases a mucous fistula was converted into a Hartmann pouch; a preference for the Hartmann pouch in patients undergoing repeated explorations is discussed. Colorectal continuity was subsequently restored in 23 patients (76.6 percent).
Schein
M
M
Department of Surgery, J.G. Strijdom Hospital, Johannesburg, South Africa.
Decker
G
G
D000006:Abdomen, Acute / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000293:injuries*; D003110:Colonic Neoplasms / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D004239:Diverticulitis, Colonic / Q000601:surgery*; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013530:Surgical Wound Infection / Q000453:epidemiology