Kazem Shahmoradi Mohammad, Khoshdani Farahani Parham, Sharifian Masoud
Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
Ann Med Surg (Lond). 2021 Jan 19;62:160-163. doi: 10.1016/j.amsu.2021.01.019. eCollection 2021 Feb.
The aim of this study is to compare the short outcomes of two methods of sigmoid resection and primary anastomosis with sigmoid resection and end colostomy (Hartmann's procedure) for sigmoid volvulus.
This retrospective study included 102, of which 56 patients underwent end colostomy (Hartmann's procedure) and 46 patients underwent resection and primary anastomosis for sigmoid volvulus. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, short-term postoperative outcomes and mortality.
The mean age of patients in the groups of Hartmann's procedure and primary anastomosis were 68.23 ± 13.42 and 70.10 ± 12.71, respectively. From the 46 patients who had primary colorectal anastomosis, 2 patients (4.3%) suffered from anastomosis leakage, which was not significantly different. This study showed that anastomosis leakage, prolonged ileus, bleeding, surgical site infection and fascial dehiscence were not different between Hartmann's procedure and primary anastomosis, significantly, p < 0.05. Hospital stay in the Hartmann group was less than primary anastomosis group in the same admission, p = 0.04. The mortality rate was not statistically different among the two groups, p = 0.549.
Postoperative complications and mortality rate do not different among the two groups however, the duration of hospitalization was lesser in Hartmann's procedure group.
本研究旨在比较乙状结肠扭转的两种乙状结肠切除及一期吻合方法与乙状结肠切除及末端结肠造口术（哈特曼手术）的短期疗效。
这项回顾性研究纳入了102例患者，其中56例行末端结肠造口术（哈特曼手术），46例行乙状结肠扭转切除及一期吻合术。回顾患者的病历以评估患者特征、手术数据、术后短期疗效和死亡率。
哈特曼手术组和一期吻合术组患者的平均年龄分别为68.23±13.42岁和70.10±12.71岁。在46例行结直肠一期吻合术的患者中，2例（4.3%）发生吻合口漏，差异无统计学意义。本研究表明，哈特曼手术和一期吻合术在吻合口漏、肠梗阻延长、出血、手术部位感染和筋膜裂开方面差异均无统计学意义，p<0.05。哈特曼组在同一住院期间的住院时间短于一期吻合术组，p=0.04。两组的死亡率差异无统计学意义，p=0.549。
两组术后并发症和死亡率无差异，然而，哈特曼手术组的住院时间较短。
