Primary anastomosis with transverse colostomy, as an alternative to Hartmann's procedure?
Date
1995
Authors
Maddern, G.
Nejari, Y.
Dennison, A.
Siriser, F.
Bardoxoglou, E.
Launois, B.
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Journal article
Citation
British Journal of Surgery, 1995; 82(2):170-171
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G. J. Maddern, Y. Nejjari, A. Dennison, F. Siriser, E. Bardoxaglou, B. Launois
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Abstract
Hartmann's procedure remains the favoured option in patients with acute left colonic and sigmoid disease, despite the well documented morbidity and mortality associated with reversal. In 40 patients with left colonic pathology, primary anastomosis was performed; 32 had a covering transverse colostomy. There were six hospital deaths, five in the transverse colostomy group. Closure was not attempted in seven of the 27 patients surviving with a colostomy (three refused, four had disseminated malignancy). In the 20 undergoing closure, there was no morbidity or mortality. With advances in intensive care, antibiotic therapy and anaesthesia, it is reasonable to consider alternatives to Hartmann's procedure, particularly when subsequent reconstruction is envisaged.
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© 1995 British Journal of Surgery Society Ltd.