Bisogno M L, Puntillo G, Aicardi P, Andrich R, Antonelli D, Cirillo C, Cordaro G, Ferrini L, Grifoni G, Mostacci D, Rabuffi F, Ruotolo F
I Divisione Chirurgica, Azienda Ospedaliera S. Giovanni, Addolorata di Roma.
Ann Ital Chir. 1998 Jan-Feb;69(1):81-6; discussion 86-7.
The Hartmann procedure has, in emergency colo-rectal surgery, many implications. The decision is based on clinical, radiological, instrumental and pathological findings. The authors report the results of 76 Hartmann's procedures performed between 1986 and 1995 and compare their results with those found in the current medical literature on the topic. In particular, they draw attention to an increased use of this procedures in colo-rectal emergencies; the morbility and mortality rates confirm the severity of the clinical cases that can be treated with this operation. To improve results the authors propose a therapeutic plan that uses a score for stratification of the risk (MPI, APA-CHE II, SSI, Hinchey); so the surgeon can choose the best surgical operation. Finally, the authors underline the importance of the principles of oncology surgery in colo-rectal cancer.
哈特曼手术在急诊结直肠手术中有诸多影响。该决策基于临床、放射学、器械检查及病理结果。作者报告了1986年至1995年间施行的76例哈特曼手术的结果,并将其与当前关于该主题的医学文献中的结果进行比较。他们特别指出,这种手术在结直肠急诊中的使用有所增加;发病率和死亡率证实了可通过该手术治疗的临床病例的严重性。为改善结果,作者提出了一种治疗方案,该方案使用一个风险分层评分(MPI、APA - CHE II、SSI、欣奇);这样外科医生就能选择最佳手术方式。最后,作者强调了肿瘤外科手术原则在结直肠癌中的重要性。