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Table of Contents
Vol. 22, No. 6, 2005
Issue release date: April 2006
Section title: Original Paper
Dig Surg 2005;22:419–425
(DOI:10.1159/000091444)

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

Oomen J.L.T.a · Cuesta M.A.b · Engel A.F.a
aDepartment of Surgery, Zaans Medical Centre, Zaandam, and bDepartment of Surgery, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 28, 2005
Accepted: August 15, 2005
Published online: April 21, 2006
Issue release date: April 2006

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 5

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

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.

© 2005 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 28, 2005
Accepted: August 15, 2005
Published online: April 21, 2006
Issue release date: April 2006

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 5

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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