학술논문

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
Document Type
Clinical report
Author
Perrone, GennaroGiuffrida, MarioAbu-Zidan, FikriKruger, Vitor F.Livrini, MarcoPetracca, Gabriele LucianoRossi, GiorgioTarasconi, AntonioTian, Brian W. C. A.Bonati, ElenaMentz, RicardoMazzini, Federico N.Campana, Juan P.Gasser, ElisabethKafka-Ritsch, ReinholdFelsenreich, Daniel M.Dawoud, ChristopherRiss, StefanGomes, Carlos AugustoGomes, Felipe CoutoGonzaga, Ricardo Alessandro TeixeiraCanton, Cassio Alfred BrattigPereira, Bruno MonteiroFraga, Gustavo P.Zem, Leticia GonçalvesCordeiro-Fonseca, Viniciusde Mesquita Tauil, RenatoAtanasov, BoykoBelev, NikolayKovachev, NikolaMeléndez, L. Juan JoséDimova, AnaDimov, StefanZeliÄ, ZdravkoAugustin, GoranBogdaniÄ, BrankoMoriÄ, TrpimirChouillard, ElieBajul, MelindaDe Simone, BelindaPanis, YvesEsposito, FrancescoNotarnicola, MargheritaLauka, LeldeFabbri, AnnaHentati, HassenFnaiech, IskanderAurélien, VenaraBougard, MarieRoulet, MaximeDemetrashvili, ZazaPipia, IrakliMerabishvili, GiorgiBouliaris, KonstantinosKoukoulis, GeorgiosDoudakmanis, ChristosXenaki, SofiaChrysos, EmmanuelKokkinakis, StamatiosVassiliu, PanteleimonMichalopoulos, NikolaosMargaris, IoannisKechagias, AristotelisAvgerinos, KonstantinosKatunin, JevgeniLostoridis, EftychiosNagorni, Eleni-AikateriniPujante, AntonioMulita, FranceskMaroulis, IoannisVailas, MichailMarinis, AthanasiosSiannis, IoannisBourbouteli, EiriniManatakis, Dimitrios K.Tasis, NikolaosAcheimastos, VasileiosMaria, SotiropoulouStylianos, KapirisKuzeridis, HarilaosKorkolis, DimitriosFradelos, EvangelosKavalieratos, GeorgePetropoulou, ThaliaPolydorou, AndreasPapacostantinou, IoannisTriantafyllou, TaniaKimpizi, DespinaTheodorou, DimitriosToutouzas, KonstantinosChamzin, AlexandrosFrountzas, MaximosSchizas, DimitriosKaravokyros, IoannisSyllaios, AthanasiosCharalabopoulos, AlexandrosBoura, MariaBaili, EfstratiaIoannidis, OrestisLoutzidou, LydiaAnestiadou, ElissavetTsouknidas, IoannisPetrakis, GeorgiosPolenta, EleniBains, LovenishGupta, RahulSingh, Sudhir K.Khanduri, ArchanaBala, MikloshKedar, AsafPisano, MarcelloPodda, MauroPisanu, AdolfoMartines, GennaroTrigiante, GiuseppeLantone, GiulianoAgrusa, AntoninoDi Buono, GiuseppeBuscemi, SalvatoreVeroux, MassimilianoGioco, RossellaVeroux, GastoneOragano, LuigiZonta, SandroLovisetto, FedericoFeo, Carlo V.Pesce, AntonioFabbri, NicolòLantone, GiulioMarino, FabioPerrone, FabrizioVincenti, LeonardoPapagni, VincenzoPicciariello, ArcangeloRossi, StefanoPicardi, BiagioDel Monte, Simone RossiVisconti, DiegoOsella, GiuliaPetruzzelli, LucaPignata, GiustoAndreuccetti, JacopoD'Alessio, RossellaBuonfantino, MassimoGuaitoli, EleonoraSpinelli, StefanoSampietro, Gianluca MatteoCorbellini, CarloLorusso, LeonardoFrontali, AlicePezzoli, IsabellaBonomi, AlessandroChierici, AndreaCotsoglou, ChristianManca, GiuseppeDelvecchio, AntonellaMusa, NicolaCasati, MassimilianoLetizia, LafaceAbate, EmmanueleErcolani, GiorgioD'Acapito, FabrizioSolaini, LeonardoGuercioni, GianlucaCicconi, SimoneSasia, DiegoBorghi, FeliceGiraudo, GiorgioSena, GiuseppeCastaldo, PasqualeCardamone, EugeniaPortale, GiuseppeZuin, MatteoSpolverato, YleniaEsposito, MarialusiaIsernia, Roberta MariaDi Salvo, MariaManunza, RominaEsposito, GiuseppeAgus, MarcelloAsti, Emanuele Luigi GiuseppeBernardi, Daniele TizianoTonucci, Tommaso PaniciLuppi, DavideCasadei, MassimilianoBonilauri, StefanoPezzolla, AngelaPanebianco, AnnunziataLaforgia, RitaDe Luca, MaurizioZese, MonicaParini, DarioJovine, ElioDe Sario, GiuseppinaLombardi, RaffaeleAprea, GiovanniPalomba, GiuseppeCapuano, MariannaArgenio, GiulioOrio, GianlucaArmellino, Mariano FortunatoTroian, MarinaGuerra, MartinaNagliati, CarloBiloslavo, AlanGermani, PaolaAizza, GiadaMonsellato, IgorChahrour, Ali ChaoukiAnania, GabrieleBombardini, CristinaBagolini, FrancescoSganga, GabrieleFransvea, PietroBianchi, ValentinaBoati, PaoloFerrara, FrancescoPalmieri, FrancescoCianci, PasqualeGattulli, DomenicoRestini, EnricoCillara, NicolaCannavera, AlessandroNita, Gabriela ElisaSarnari, JleniaRoscio, FrancescoClerici, FedericoScandroglio, IldoBerti, StefanoCadeo, AlessandroFilippelli, AliceConti, LuigiGrassi, CarmineCattaneo, Gaetano MariaPighin, MarinaPapis, DavideGambino, GiovanniBertino, VanessaSchifano, DomenicoPrando, DanielaFogato, LuisellaCavallo, FabioAnsaloni, LucaPicheo, RobertoPontarolo, NicholasDepalma, NormaSpampinato, MarcelloD'Ugo, StefanoLepre, LucaCapponi, Michela GiuliiCampa, Rossella DomenicaSarro, GiulianoDinuzzi, Vincenza PaolaOlmi, StefanoUccelli, MatteoFerrari, DavideInama, MarcoMoretto, GianluigiFontana, MicheleFavi, FrancescoPicariello, ErikaRampini, AlessiaBarberis, AndreaAzzinnaro, AntonioOliva, AlbaTotaro, LuigiBenzoni, IlariaRanieri, ValerioCapolupo, Gabriella TeresaCarannante, FilippoCaricato, MarcoRonconi, MaurizioCasiraghi, SilviaCasole, GiovanniPantalone, DesireAlemanno, GiovanniScheiterle, MaximilianCeresoli, MarcoCereda, MarcoFumagalli, ChiaraZanzi, FedericoBolzon, StefanoGuerra, EnricoLecchi, FrancescaCellerino, PaolaArdito, AntonellaScaramuzzo, RosaBalla, AndreaLepiane, PasqualeTartaglia, NicolaAmbrosi, AntonioPavone, GiovannaPalini, Gian MarcoVeneroni, SimoneGarulli, GianlucaRicci, ClaudioTorre, BeatriceRusso, Iris ShariRottoli, MatteoTanzanu, MartaBelvedere, AngelaMilone, MarcoManigrasso, MicheleDe Palma, Giovanni DomenicoPiccoli, MicaelaPattacini, Gianmaria CasoniMagnone, StefanoBertoli, PaoloPisano, MicheleMassucco, PaoloPalisi, MarcoLuzzi, Andrea-PierreFleres, FrancescoClarizia, GuglielmoSpolini, AlessandroKobe, YoshiroToma, TakayukiShimamura, FumihikoParker, RobertRanketi, SinkeetMitei, MercySvagzdys, SauliusPauzas, HenrikasZilinskas, JustasPoskus, TomasKryzauskas, MariusJakubauskas, MatasZakaria, Andee DzulkarnaenZakaria, ZaidiWong, Michael Pak-KaiJusoh, Asri CheZakaria, Muhammad NazreenCruz, Daniel RiosElizalde, Aurea Barbara RodriguezReynaud, Alejandro BaéonHernandez, Edgard Efren LozadaMonroy, Jose maria Victor PalomoHinojosa-Ugarte, DiegoQuiodettis, MarthaDu Bois, María EstherLatorraca, JoséMajor, PiotrPÄdziwiatr, MichaÅPisarska-Adamczyk, MagdalenaWalÄdziak, MaciejKwiatkowski, AndrzejCzyżykowski, Åukaszda Costa, Silvia DantasPereira, BelaFerreira, Ana Rita OliveiraAlmeida, FilipeRocha, RicardoCarneiro, CarlaPerez, Diego PitaCarvas, JoãoRocha, CatarinaFerreira, CátiaMarques, RitaFernandes, UrâniaLeao, PedroGoulart, AndréPereira, Rita GonçalvesPatrocínio, Sara Daniela Direitode Mendonça, Nuno Gonçalo GonçalvesManso, Maria Isabel CerqueiraMorais, Henrique Manuel CardosoCardoso, Paulo SebastiãoCalu, ValentinMiron, AdrianToma, Elena AdelinaGachabayov, MahirAbdullaev, AbakarLitvin, AndreyNechay, TarasTyagunov, AlexanderYuldashev, AnvarBradley, AlisonWilson, MichaelPanyko, ArpádLátecková, ZuzanaLacko, VladimírLesko, DusanSoltes, MarekRadonak, JozefTurrado-Rodriguez, VictorTermes-Serra, RoserMorales-Sevillano, XavierLapolla, PierfrancescoMingoli, AndreaBrachini, GioiaDegiuli, MaurizioSofia, SilviaReddavid, Rossellade Manzoni Garberini, AndreaBuffone, Angelicadel Pozo, Eduardo PereaAparicio-Sánchez, DanielDos Barbeito, SandraEstaire-Gómez, MercedesVitón-Herrero, Rebecade los Ãngeles Gil Olarte-Marquez, MªGil-Martínez, JoséAlconchel, FelipeNicolás-López, TatianaRahy-Martin, Aida CristinaPelloni, MaríaBaéolas-Suarez, RaquelMendoza-Moreno, FernandoNisa, Francisca García-MorenoDíez-Alonso, ManuelRodas, María Elisa ValleAgundez, María CarmonaAndrés, María Inmaculada PérezMoreira, Claudia Cristina LopesPerez, Aintzane LizarazuPonce, Iéigo AugustoGonzález-Castillo, Ana MaríaMembrilla-Fernández, EstelaSalvans, SilviaSerradilla-Martín, MarioPardo, Pablo SanchoRivera-Alonso, DanielDziakova, JanaHuguet, Jose MugüerzaValle, Naila PagèsRuiz, Enrique ColásValcárcel, Cristina ReyMoreno, Cristina RuizSalazar, Yeniffer Tatiana MorenoGarcía, Juan Jesús RubioMicó, Silvia SevilaLópez, Joaquín RuizFarré, Silvia PérezGomez, Maite SantamariaPetit, Nuria MestresTitos-García, AlbertoAranda-Narváez, Jose ManuelRomacho-López, LauraSánchez-Guillén, LuisAranaz-Ostariz, VeronicaBosch-Ramírez, MarinaMartínez-Pérez, AleixMartínez-López, ElíasSebastián-Tomás, Juan CarlosJimenez-Riera, GranadaJimenez-Vega, JavierCuellar, Jose Aurelio NavasCampos-Serra, AndreaMuéoz-Campaéa, AnnaGràcia-Roman, RaquelAlegre, Javier MartínezPinto, Francisca LimaO'Sullivan, Sara NuéezAntona, Francisco BlancoJiménez, Beatriz MuéozLópez-Sánchez, JaimeCarmona, Zahira GómezFernández, Rocio TorresSierra, Isabel Blesade León, Laura Román GarcíaMoreno, Verónica PolainoIglesias, EvaCumplido, Paola LoraBravo, Altea ArangoSimó, Ignacio ReyDomínguez, Carlota LópezCaamaéo, Aloia GuerreiroLozano, Rafael CallejaMartínez, Manuel DuránTorres, Ãlvaro Naranjode Quiros, Javier Tomas Morales BernaldoPellino, GianlucaCloquell, Miriam MoratalMoller, Elsa GarcíaJalal-Eldin, SamiAbdoun, Ahmed K.Hamid, Hytham K. S.Lohsiriwat, VarutMongkhonsupphawan, AitsariyaBaraket, OussamaAyed, KarimAbbassi, ImedAli, Ali BenAmmar, HoussemKchaou, AliTlili, AhmedZribi, ImenColak, ElifPolat, SuleymanKoylu, Zehra AlanGuner, AliUsta, Mehmet ArifReis, Murat EmreMantoglu, BarisGonullu, EmreAkin, EmrahAltintoprak, FatihBayhan, ZulfuFirat, NecattinIsik, ArdaMemis, UfukBayrak, MehmetAltintaÅ, YaseminKara, YasinBozkurt, Mehmet AbdussametKocataÅ, AliDas, KoraySeker, AhmetOzer, NazmiAtici, Semra DemirliTuncer, KorhanKaya, TayfunOzkan, ZeynepIlhan, OnurAgackiran, IbrahimUzunoglu, Mustafa YenerDemirbas, ErenAltinel, YukselMeric, SerhatHacim, Nadir AdnanUymaz, Derya SalimOmarov, NailBalik, EmreTebala, Giovanni D.Khalil, HanyRana, MridulKhan, MansoorFlorence, CharlotteSwaminathan, ChristieLeo, Cosimo AlexLiasis, LamprosWatfah, JosefTrostchansky, IvanDelgado, EdwardPontillo, MarceloLatifi, RifatCoimbra, RaulEdwards, SaraLopez, AnaVelmahos, GeorgeDorken, AnderGebran, AnthonyPalmer, AmandaOury, JeffreyBardes, James M.Seng, Sirivan SuonCoffua, Lauren S.Ratnasekera, AsanthiEgodage, TanyaEcheverria-Rosario, KarlaArmento, IsabellaNapolitano, Lena M.Sangji, Naveen F.Hemmila, MarkQuick, Jacob A.Austin, Tyler R.Hyman, Theodore S.Curtiss, WilliamMcClure, AmandaCairl, NicholasBiffl, Walter L.Truong, Hung P.Schaffer, KathrynReames, SummerBanchini, FilippoCapelli, PatrizioCoccolini, FedericoSartelli, MassimoBravi, FrancescaVallicelli, CarloAgnoletti, VanniBaiocchi, Gian LucaCatena, Fausto
Source
World Journal of Emergency Surgery. April 16, 2024, Vol. 19 Issue 1
Subject
Mortality -- Usage
Colorectal cancer -- Usage -- Health aspects
Clinical trials -- Health aspects -- Usage
Gastrointestinal diseases -- Usage -- Health aspects
Surgery -- Usage -- Health aspects
Language
English
ISSN
1749-7922
Abstract
Background Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results 564 patients (43.1%) were females. The mean age was 65.9 [+ or -] 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo [greater than or equal to] 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score ([less than or equal to] 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception. Keywords: Hartmann's procedure, Ostomy, Emergency surgery, Resection, Primary anastomosis, Left side, Colon, Diverticulitis, Colorectal cancer
Author(s): Gennaro Perrone[sup.1], Mario Giuffrida[sup.2,3], Fikri Abu-Zidan[sup.4], Vitor F. Kruger[sup.5], Marco Livrini[sup.1], Gabriele Luciano Petracca[sup.1], Giorgio Rossi[sup.1], Antonio Tarasconi[sup.6], Brian W. C. A. Tian[sup.7], Elena Bonati[sup.2], Ricardo Mentz[sup.8], Federico N. [...]