Effectiveness of Hartmann procedure for diffuse peritonitis by sigmoid diverticular perforation: decrease in mortality: no mortality below 85 years.

Seance of wednesday 17 december 2003 (pas de sujet Principal)

Abstract

Study aim: The aim of this retrospective study was to report theresult of Hartmann procedure in diffuse peritonitis by sigmoiddiverticular perforation. Mortality, morbidity and reanastomosisrate were evaluated.Patients and methods: From 1987 to 2002, 62 patients (32 men,30 women) were operated on by the same surgical team for diffuseperitonitis by sigmoid diverticular perforation; Hartmannprocedure with Mickulicz drainage was done. Group A (n= 39) ofage below 75, group B1 (n=15), of age 76-85 and group B2 (n=9),of age 86-94, were studiedResults : Mortality was 6% (4/62) all in group B2 ; mean hospitalstay was 19 days (14-6 ) in group A and 21 days (6-40) in group B(p>0.05) ; reanastomosis was 97.4% (38/39) in group A after amean period of 4,5 months (3-11) with uneventful outcome. In Bgroup 52% were reoperated (10 of 19 survivors) without morbidity.Conclusion: Hartmann procedure remains a very safe operationfor diffuse peritonitis by sigmoid diverticular perforation; in ourseries there was no mortality in patients below 85 years, with adecrease of global mortality.