Ulus Travma Acil Cerrahi Derg. 2020; 26(2): 255-259 | DOI: 10.14744/tjtes.2019.71725

Hartmann kapatýlmasý prosedürü hâlâ yüksek morbiditeli bir cerrahi midir?

Ozan Akýncý¹, Müge Yurdacan², Baþar Can Turgut², Server Sezgin Uludað², Osman Þimþek^2
1Hakkari Devlet Hastanesi, Genel Cerrahi Kliniði, Hakkari
²Ýstanbul Üniversitesi-Cerrahpaþa, Cerrahpaþa Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Ýstanbul

AMAÇ: Bu çalýþma Hartmann prosedürü kapatýlmasýnýn ameliyat öncesi ve ameliyat sýrasýnda risk faktörlerine dayanarak sonuçlarýný deðerlendirmektedir.
GEREÇ VE YÖNTEM: Kliniðimizde Ocak 2010–Ocak 2016 yýllarý arasýnda Hartmann prosedürü uygulanan 78 olgu geriye dönük olarak incelendi.
BULGULAR: Olgularýn 45’i erkek, 33’ü kadýndý. Olgularýn 32’si malignite, 15’i divertikül perforasyonu, 11’i sigmoid volvulus nedeniyle ameliyat edilmiþtir. Otuz iki olguda Hartmann kapatýlmasý yapýlabilmiþtir. Hartmann kapatýlmasý için morbidite ve mortalite oranlarý sýrasýyla %37.5–%0.0 idi.
TARTIÞMA: Hartmann prosedürü kapatýlmasý kabul edilebilir morbidite oranlarý ile güvenilir bir cerrahi olarak görünmektedir. Doðru hasta seçimi, doðru operasyon zamanlamasý ve titiz bir cerrahi hazýrlýk yapýldýðý takdirde Hartmann prosedürü kapatýlmasýnýn morbidite ve mortalite riski minimalize edilebilir.

Anahtar Kelimeler: Hartmann kapatýlmasý, Hartmann prosedürü, morbidite; mortalite.

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Reversal of Hartmann’s procedure is still a high-morbid surgery?

Ozan Akýncý¹, Müge Yurdacan², Baþar Can Turgut², Server Sezgin Uludað², Osman Þimþek^2
1Department of General Surgery, Hakkari State Hospital, Hakkari-Turkey
²Department of General Surgery, Ýstanbul University-Cerrahpaþa, Cerrahpaþa Faculty of Medicine, Ýstanbul-Turkey

BACKGROUND: This study evaluated the outcome of the reversal of Hartmann’s procedure based on preoperative and intraoperative risk factors.
METHODS: We retrospectively reviewed 78 cases, whom we applied the Hartmann’s procedure either electively or under emergency conditions in our clinic between the years 2010 and 2016.
RESULTS: Of the cases reviewed in this study, 45 patients were males, and 33 patients were females. Of all cases included in this study, 32 cases were operated due to malignancies, 15 cases were operated due to a perforated diverticulum, and 11 cases were operated due to sigmoid volvulus. Reversal of Hartmann’s was performed in 32 cases. The morbidity and mortality rates for the reversal of Hartmann’s procedure were 37.5% and 0.0%, respectively.
CONCLUSION: The reversal of Hartmann’s procedure appears to be a safe operation with acceptable morbidity rates. If the correct patient selection, correct operation timing and meticulous surgical preparation are performed, the risk of morbidity and mortality of the reversal of Hartmann’s procedure can be minimized.

Keywords: Hartmann’s procedure, morbidity; mortality; the reversal of Hartmann.

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