title: [Evolution of indications for Hartmann's operation. Reflexions on a series of 160 cases].
abstract: The authors report the results and indications of 160 Hartmann's procedures performed over a period of 15 years. Between 1978 and 1992, 160 patients (90 males, 70 females), with a mean age of 72, underwent Hartmann's procedure for rectosigmoid carcinoma in 55% of cases, for complications of sigmoid diverticulitis in 36% and for other lesions in 14%. Hartmann's procedure was performed either electively (42%) or as an emergency (58%) with a mortality of 6% and 32% respectively. The majority of complications included wound infections or intraperitoneal abscess, and the overall morbidity was 30%. Re-establishment of bowel continuity was performed in 30.7% of patients, most of whom had been initially operated as an emergency for a benign lesion. These 160 cases of Hartmann's procedure represent 27% of the 590 operations performed during the same period as an emergency or electively for rectosigmoid lesion. Hartmann's procedure remains a most effective technique for emergency surgery for benign or malignant lesions with colonic septic complications, and is also indicated electively for palliative treatment of rectosigmoid carcinoma.
authors.affiliation: Service de Chirurgie Générale et Digestive, CHU Hôpital Robert-Debré, Reims.
authors.forename: C
authors.initials: C
authors.lastname: Avisse
authors.forename: D
authors.initials: D
authors.lastname: Greffier
authors.forename: J P
authors.initials: JP
authors.lastname: Palot
authors.forename: J F
authors.initials: JF
authors.lastname: Delattre
authors.forename: J B
authors.initials: JB
authors.lastname: Flament
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000401:mortality / Q000601:surgery*; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012811:Sigmoid Neoplasms / Q000401:mortality / Q000601:surgery*
vernacular_title: Evolution des indications de l'opération de Hartmann. Réflexions à propos d'une série de 160 observations.