Kästel M, Schultheis K H, Haubenreisser F, Gebhardt C
Abteilung für Abdominal-, Thorax- und endokrine Chirurgie, Klinikum Nürnberg-Nord.
Langenbecks Arch Chir Suppl Kongressbd. 1997;114:1202-4.
A total of 112 patients were operated on for severe complicated sigmoid diverticulitis, Hartmann's procedure was performed due to local or generalised peritonitis, 80% to them as emergency surgery. There was a mortality of 18.8% due to the sepsis or other complications. Sixty-two of the remaining 80 patients underwent a restorative procedure without any mortality and low morbidity (11 died after discharge not related to the colon disease). Resection and primary anastomsis is always the first choice, but in cases of severe peritonitis there is no discomfort or risk for the patient if Hartmann's procedure with restorative surgery is chosen.
共有112例患者因严重复杂性乙状结肠憩室炎接受手术,因局部或全身性腹膜炎行Hartmann手术,其中80%为急诊手术。因脓毒症或其他并发症导致的死亡率为18.8%。其余80例患者中有62例行修复手术,无死亡病例,发病率低(11例出院后死亡,与结肠疾病无关)。切除并一期吻合始终是首选,但在严重腹膜炎的情况下,如果选择Hartmann手术加修复性手术,对患者没有不适或风险。