Results of emergency Hartmann's operation for obstructive or perforated left-sided colorectal cancer.

World Journal of Surgical Oncology
Pierre CharbonnetPhilippe Morel

Abstract

Up to 15% of colorectal cancer (CRC) patients present with obstructive or perforated tumours, and require emergency surgery. The Hartmann's procedure (HP) provides the opportunity to achieve a potentially curative (R0) resection, while minimizing surgical trauma in poor-risk patients. The aim of this study was to assess the surgical (operative mortality), and oncological (long-term survival after curative resection) results of emergency HP for obstructive or perforated left-sided CRC. A retrospective review of 50 patients who underwent emergency HP for perforated/obstructive CRC in our institution between 1995 and 2006. Median age of patients was 75 (range 22-95) years and the indications for HP were obstruction (32) and perforation (18 patients). Operative mortality and morbidity were 8% and 26% respectively. 35 patients (70%) were operated with a curative intent; in this group, overall 1-, 3- and 5-year survival rates were 80%, 54% and 40%. In univariate analysis, the presence of lymph node metastases was associated with poor 5-year survival (62% [Stage II] vs. 27% [Stage III], log-rank test, p = 0.02). Eleven patients (22%) had their operation reversed with a median delay of 225 (range 94-390) days. In this subgroup, two pat...Continue Reading

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Citations

Feb 6, 2014·The Journal of Surgical Research·Kevin R KastenIan M Paquette
Oct 15, 2010·Expert Review of Anticancer Therapy·Frank SchwenterPascal Gervaz
Feb 4, 2011·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Hee Seung KimSoon-Beom Kang
Aug 8, 2015·International Journal of Colorectal Disease·M DanielsW Hohenberger
Jul 21, 2009·International Journal of Surgery·Alan A Saber, Tarek H El-Ghazaly
Jan 17, 2015·International Surgery·John HoganJohn Calvin Coffey
Oct 12, 2017·Revista do Colégio Brasileiro de Cirurgiões·Rodrigo Felippe RamosRicardo Ary Leal
Nov 6, 2014·Scandinavian Journal of Gastroenterology·Michael WilhelmsenHans Jørgen Nielsen
May 28, 2020·Minerva chirurgica·Carlo BergaminiPaolo Prosperi

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