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Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
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| Title: | Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago |
| Authors: | Perrone, G Giuffrida, M Abu-Zidan, F Kruger, VF Livrini, M Petracca, GL Rossi, G Tarasconi, A Tian, BWCA Bonati, E Mentz, R Mazzini, FN Campana, JP Gasser, E Kafka-Ritsch, R Felsenreich, DM Dawoud, C Riss, S Gomes, CA Gomes, FC Teixeira Gonzaga, RA Brattig Canton, CA Pereira, BM Fraga, GP Zem, LG Cordeiro-Fonseca, V Tauil, RDM Atanasov, B Belev, N Kovachev, N Melendez, LJJ Dimova, A Dimov, S Zelic, Z Augustin, G Bogdanic, B Moric, T Chouillard, E Bajul, M De Simone, B Panis, Y Esposito, F Notarnicola, M Lauka, L Fabbri, A Hentati, H Fnaiech, I Aurelien, V Bougard, M Roulet, M Demetrashvili, Z Pipia, I Merabishvili, G Bouliaris, K Koukoulis, G Doudakmanis, C Xenaki, S Chrysos, E Kokkinakis, S Vassiliu, P Michalopoulos, N Margaris, I Kechagias, A Avgerinos, K Katunin, J Lostoridis, E Nagorni, E-A Pujante, A Mulita, F Maroulis, I Vailas, M Marinis, A Siannis, I Bourbouteli, E Manatakis, DK Tasis, N Acheimastos, V Maria, S Stylianos, K Kuzeridis, H Korkolis, D Fradelos, E Kavalieratos, G Petropoulou, T Polydorou, A Papacostantinou, I Triantafyllou, T Kimpizi, D Theodorou, D Toutouzas, K Chamzin, A Frountzas, M Schizas, D Karavokyros, I Syllaios, A Charalabopoulos, A Boura, M Baili, E Ioannidis, O Loutzidou, L Anestiadou, E Tsouknidas, I Petrakis, G Polenta, E Bains, L Gupta, R Singh, SK Khanduri, A Bala, M Kedar, A Pisano, M Podda, M Pisanu, A Martines, G Trigiante, G Lantone, G Agrusa, A Di Buono, G Buscemi, S Veroux, M Gioco, R Veroux, G Oragano, L Zonta, S Lovisetto, F Feo, CV Pesce, A Fabbri, N Lantone, G Marino, F Perrone, F Vincenti, L Papagni, V Picciariello, A Rossi, S Picardi, B Del Monte, SR Visconti, D Osella, G Petruzzelli, L Pignata, G Andreuccetti, J D'Alessio, R Buonfantino, M Guaitoli, E Spinelli, S Sampietro, GM Corbellini, C Lorusso, L Frontali, A Pezzoli, I Bonomi, A Chierici, A Cotsoglou, C Manca, G Delvecchio, A Musa, N Casati, M Letizia, L Abate, E Ercolani, G D'Acapito, F Solaini, L Guercioni, G Cicconi, S Sasia, D Borghi, F Giraudo, G Sena, G Castaldo, P Cardamone, E Portale, G Zuin, M Spolverato, Y Esposito, M Isernia, RM Di Salvo, M Manunza, R Esposito, G Agus, M Asti, ELG Bernardi, DT Tonucci, TP Luppi, D Casadei, M Bonilauri, S Pezzolla, A Panebianco, A Laforgia, R De Luca, M Zese, M Parini, D Jovine, E De Sario, G Lombardi, R Aprea, G Palomba, G Capuano, M Argenio, G Orio, G Armellino, MF Troian, M Guerra, M Nagliati, C Biloslavo, A Germani, P Aizza, G Monsellato, I Chahrour, AC Anania, G Bombardini, C Bagolini, F Sganga, G Fransvea, P Bianchi, V Boati, P Ferrara, F Palmieri, F Cianci, P Gattulli, D Restini, E Cillara, N Cannavera, A Nita, GE Sarnari, J Roscio, F Clerici, F Scandroglio, I Berti, S Cadeo, A Filippelli, A Conti, L Grassi, C Cattaneo, GM Pighin, M Papis, D Gambino, G Bertino, V Schifano, D Prando, D Fogato, L Cavallo, F Ansaloni, L Picheo, R Pontarolo, N Depalma, N Spampinato, M D'Ugo, S Lepre, L Capponi, MG Campa, RD Sarro, G Dinuzzi, VP Olmi, S Uccelli, M Ferrari, D Inama, M Moretto, G Fontana, M Favi, F Picariello, E Rampini, A Barberis, A Azzinnaro, A Oliva, A Totaro, L Benzoni, I Ranieri, V Capolupo, GT Carannante, F Caricato, M Ronconi, M Casiraghi, S Casole, G Pantalone, D Alemanno, G Scheiterle, M Ceresoli, M Cereda, M Fumagalli, C Zanzi, F Bolzon, S Guerra, E Lecchi, F Cellerino, P Ardito, A Scaramuzzo, R Balla, A Lepiane, P Tartaglia, N Ambrosi, A Pavone, G Palini, GM Veneroni, S Garulli, G Ricci, C Torre, B Russo, IS Rottoli, M Tanzanu, M Belvedere, A Milone, M Manigrasso, M De Palma, GD Piccoli, M Pattacini, GC Magnone, S Bertoli, P Pisano, M Massucco, P Palisi, M Luzzi, A-P Fleres, F Clarizia, G Spolini, A Kobe, Y Toma, T Shimamura, F Parker, R Ranketi, S Mitei, M Svagzdys, S Pauzas, H Zilinskas, J Poskus, T Kryzauskas, M Jakubauskas, M Zakaria, AD Zakaria, Z Wong, MP-K Jusoh, AC Zakaria, MN Cruz, DR Elizalde, ABR Reynaud, AB Hernandez, EEL Monroy, JMVP Hinojosa-Ugarte, D Quiodettis, M Du Bois, ME Latorraca, J Major, P Pedziwiatr, M Pisarska-Adamczyk, M Waledziak, M Kwiatkowski, A Czyzykowski, L Da Costa, SD Pereira, B Ferreira, ARO Almeida, F Rocha, R Carneiro, C Perez, DP Carvas, J Rocha, C Ferreira, C Marques, R Fernandes, U Leao, P Goulart, A Pereira, RG Patrocinio, SDD De Mendonca, NGG Manso, MIC Morais, HMC Cardoso, PS Calu, V Miron, A Toma, EA Gachabayov, M Abdullaev, A Litvin, A Nechay, T Tyagunov, A Yuldashev, A Bradley, A Wilson, M Panyko, A Lateckova, Z Lacko, V Lesko, D Soltes, M Radonak, J Turrado-Rodriguez, V Termes-Serra, R Morales-Sevillano, X Lapolla, P Mingoli, A Brachini, G Degiuli, M Sofia, S Reddavid, R Garberini, ADM Buffone, A Del Pozo, EP Aparicio-Sanchez, D Dos Barbeito, S Estaire-Gomez, M Viton-Herrero, R Gil Olarte-Marquez, MDLA Gil-Martinez, J Alconchel, F Nicolas-Lopez, T Rahy-Martin, AC Pelloni, M Banolas-Suarez, R Mendoza-Moreno, F Nisa, FG-M Diez-Alonso, M Rodas, MEV Agundez, MC Perez Andres, MI Lopes Moreira, CC Lizarazu Perez, A Ponce, IA Gonzalez-Castillo, AM Membrilla-Fernandez, E Salvans, S Serradilla-Martin, M Pardo, PS Rivera-Alonso, D Dziakova, J Huguet, JM Pages Valle, N Colas Ruiz, E Rey Valcarcel, C Ruiz Moreno, C Moreno Salazar, YT Rubio Garcia, JJ Mico, SS Ruiz Lopez, J Perez Farre, S Santamaria Gomez, M Mestres Petit, N Titos-Garcia, A Aranda-Narvaez, JM Romacho-Lopez, L Sanchez-Guillen, L Aranaz-Ostariz, V Bosch-Ramirez, M Martinez-Perez, A Martinez-Lopez, E Sebastian-Tomas, JC Jimenez-Riera, G Jimenez-Vega, J Navas Cuellar, JA Campos-Serra, A Munoz-Campana, A Gracia-Roman, R Martinez Alegre, J Lima Pinto, F O'Sullivan, SN Blanco Antona, F Munoz Jimenez, B Lopez-Sanchez, J Gomez Carmona, Z Torres Fernandez, R Blesa Sierra, I Roman Garcia de Leon, L Polaino Moreno, V Iglesias, E Lora Cumplido, P Arango Bravo, A Rey Simo, I Lopez Dominguez, C Guerreiro Caamano, A Calleja Lozano, R Duran Martinez, M Naranjo Torres, A Morales Bernaldo de Quiros, JT Pellino, G Cloquell, MM Garcia Moller, E Jalal-Eldin, S Abdoun, AK Hamid, HKS Lohsiriwat, V Mongkhonsupphawan, A Baraket, O Ayed, K Abbassi, I Ben Ali, A Ammar, H Kchaou, A Tlili, A Zribi, I Colak, E Polat, S Koylu, ZA Guner, A Usta, MA Reis, ME Mantoglu, B Gonullu, E Akin, E Altintoprak, F Bayhan, Z Firat, N Isik, A Memis, U Bayrak, M Altintas, Y Kara, Y Bozkurt, MA Kocatas, A Das, K Seker, A Ozer, N Atici, SD Tuncer, K Kaya, T Ozkan, Z Ilhan, O Agackiran, I Uzunoglu, MY Demirbas, E Altinel, Y Meric, S Hacim, NA Uymaz, DS Omarov, N Balik, E Tebala, GD Khalil, H Rana, M Khan, M Florence, C Swaminathan, C Leo, CA Liasis, L Watfah, J Trostchansky, I Delgado, E Pontillo, M Latifi, R Coimbra, R Edwards, S Lopez, A Velmahos, G Dorken, A Gebran, A Palmer, A Oury, J Bardes, JM Seng, SS Coffua, LS Ratnasekera, A Egodage, T Echeverria-Rosario, K Armento, I Napolitano, LM Sangji, NF Hemmila, M Quick, JA Austin, TR Hyman, TS Curtiss, W McClure, A Cairl, N Biffl, WL Truong, HP Schaffer, K Reames, S Banchini, F Capelli, P Coccolini, F Sartelli, M Bravi, F Vallicelli, C Agnoletti, V Baiocchi, GL Catena, F |
| Item Type: | Journal Article |
| 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 ± 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 ≥ 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 (≤ 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. |
| Issue Date: | 16-Apr-2024 |
| Date of Acceptance: | 28-Mar-2024 |
| URI: | http://hdl.handle.net/10044/1/114605 |
| DOI: | 10.1186/s13017-024-00543-w |
| ISSN: | 1749-7922 |
| Publisher: | BMC |
| Journal / Book Title: | World Journal of Emergency Surgery |
| Volume: | 19 |
| Copyright Statement: | © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecom‑ mons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Publication Status: | Published |
| Article Number: | 14 |
| Online Publication Date: | 2024-04-16 |
| Appears in Collections: | Faculty of Engineering |
This item is licensed under a Creative Commons License
