Mortality and Morbidity After Hartmann’s Procedure Versus Primary Anastomosis Without a Diverting Stoma for Colorectal Perforation: A Nationwide Observational Study

2017 ◽  
Vol 42 (3) ◽  
pp. 866-875 ◽  
Author(s):  
Asuka Tsuchiya ◽  
Hideo Yasunaga ◽  
Yusuke Tsutsumi ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi
Keyword(s):  
Observational Study ◽  
Primary Anastomosis ◽  
Hartmann’S Procedure ◽  
Colorectal Perforation ◽  
Mortality And Morbidity ◽  
Hartmann's Procedure ◽  
Diverting Stoma ◽  
Nationwide Observational Study

scholarly journals Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

2021 ◽  
Vol 18 (3) ◽  
pp. 176-179
Author(s):  
Ephraim Bitilinyu-Bangoh ◽  
Fatsani Mwale ◽  
Loveness Ulunji Chawinga ◽  
Gift Mulima
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Kamuzu Central Hospital

Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to  describe the surgical  management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data  extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid  resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in  mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has  significant oedema or is gangrenous.

scholarly journals Emergency Left Colon Resection for Acute Perforation. Primary Anastomosis or Hartmann’s Procedure? A Case-matched Control Study

2007 ◽  
Vol 31 (11) ◽  
pp. 2117-2124 ◽  
Author(s):  
Stefan Breitenstein ◽  
Armin Kraus ◽  
Dieter Hahnloser ◽  
Marco Decurtins ◽  
Pierre-Alain Clavien ◽  
...  
Keyword(s):  
Matched Control ◽  
Primary Anastomosis ◽  
Colon Resection ◽  
Left Colon ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Acute Perforation ◽  
Control Study

Primary anastomosis with transverse colostomy as an alternative to Hartmann's procedure

1995 ◽  
Vol 82 (2) ◽  
pp. 170-171 ◽  
Author(s):  
G. J. Maddern ◽  
Y. Nejjari ◽  
A. Dennison ◽  
F. Siriser ◽  
E. Bardoxaglou ◽  
...  
Keyword(s):  
Primary Anastomosis ◽  
Transverse Colostomy ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure

scholarly journals Resection and Primary Anastomosis in Necrotizing Enterocolitis

1996 ◽  
Vol 89 (7) ◽  
pp. 385-388 ◽  
Author(s):  
Niyi Ade-Ajayi ◽  
Edward Kiely ◽  
David Drake ◽  
Rob Wheeler ◽  
Lewis Spitz
Keyword(s):  
Necrotizing Enterocolitis ◽  
Local Anaesthetic ◽  
Surgical Intervention ◽  
Advanced Disease ◽  
Primary Anastomosis ◽  
Mortality And Morbidity ◽  
Peritoneal Drainage ◽  
Diverting Stoma ◽  
Intestinal Involvement ◽  
Overall Mortality

Necrotizing enterocolitis (NEC) is the most common surgical emergency in the newborn. Up to half of babies with NEC develop advanced disease requiring surgical intervention. Options include peritoneal drainage under local anaesthetic, enterostomy only, resection and enterostomies, and resection with primary anastomosis. Resection with enterostomies is favoured by many paediatric surgeons but management of neonatal enterostomies can be difficult. The outcome of 26 infants undergoing surgery for advanced NEC over a 2-year period is reviewed. Resection and primary anastomosis was possible in 18 infants of whom two (11%) died. Recurrent NEC developed in four (22%) and strictures in three (17%) of these infants. An initial enterostomy was fashioned in eight infants, three following resection of necrotic intestine and five as a proximal diverting stoma in infants with pan-intestinal involvement. Five of these eight infants died (63%), giving an overall mortality of 27%. Primary anastomosis is an effective procedure following resection of grossly involved intestine in infants with NEC. The mortality and morbidity in this series compared well with those reported for staged procedures.

Generalized peritonitis due to perforated diverticulitis: Hartmann’s procedure or primary anastomosis?

2010 ◽  
Vol 26 (3) ◽  
pp. 377-384 ◽  
Author(s):  
Loris Trenti ◽  
Sebastiano Biondo ◽  
Thomas Golda ◽  
Millan Monica ◽  
Esther Kreisler ◽  
...  
Keyword(s):  
Primary Anastomosis ◽  
Hartmann’S Procedure ◽  
Perforated Diverticulitis ◽  
Hartmann's Procedure ◽  
Generalized Peritonitis
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