Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
Issued Date
2024-12-01
Resource Type
eISSN
17497922
Scopus ID
2-s2.0-85190584518
Journal Title
World Journal of Emergency Surgery
Volume
19
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
World Journal of Emergency Surgery Vol.19 No.1 (2024)
Suggested Citation
Perrone G., Giuffrida M., Abu-Zidan F., Kruger V.F., Livrini M., Petracca G.L., Rossi G., Tarasconi A., Tian B.W.C.A., Bonati E., Mentz R., Mazzini F.N., Campana J.P., Gasser E., Kafka-Ritsch R., Felsenreich D.M., Dawoud C., Riss S., Gomes C.A., Gomes F.C., Gonzaga R.A.T., Canton C.A.B., Pereira B.M., Fraga G.P., Zem L.G., Cordeiro-Fonseca V., de Mesquita Tauil R., Atanasov B., Belev N., Kovachev N., Meléndez L.J.J., Dimova A., Dimov S., Zelić Z., Augustin G., Bogdanić B., Morić T., Chouillard E., Bajul M., De Simone B., Panis Y., Esposito F., Notarnicola M., Lauka L., Fabbri A., Hentati H., Fnaiech I., Aurélien 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 D.K., 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. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago. World Journal of Emergency Surgery Vol.19 No.1 (2024). doi:10.1186/s13017-024-00543-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98091
Title
Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
Author(s)
Perrone G.
Giuffrida M.
Abu-Zidan F.
Kruger V.F.
Livrini M.
Petracca G.L.
Rossi G.
Tarasconi A.
Tian B.W.C.A.
Bonati E.
Mentz R.
Mazzini F.N.
Campana J.P.
Gasser E.
Kafka-Ritsch R.
Felsenreich D.M.
Dawoud C.
Riss S.
Gomes C.A.
Gomes F.C.
Gonzaga R.A.T.
Canton C.A.B.
Pereira B.M.
Fraga G.P.
Zem L.G.
Cordeiro-Fonseca V.
de Mesquita Tauil R.
Atanasov B.
Belev N.
Kovachev N.
Meléndez L.J.J.
Dimova A.
Dimov S.
Zelić Z.
Augustin G.
Bogdanić B.
Morić T.
Chouillard E.
Bajul M.
De Simone B.
Panis Y.
Esposito F.
Notarnicola M.
Lauka L.
Fabbri A.
Hentati H.
Fnaiech I.
Aurélien 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 D.K.
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.
Giuffrida M.
Abu-Zidan F.
Kruger V.F.
Livrini M.
Petracca G.L.
Rossi G.
Tarasconi A.
Tian B.W.C.A.
Bonati E.
Mentz R.
Mazzini F.N.
Campana J.P.
Gasser E.
Kafka-Ritsch R.
Felsenreich D.M.
Dawoud C.
Riss S.
Gomes C.A.
Gomes F.C.
Gonzaga R.A.T.
Canton C.A.B.
Pereira B.M.
Fraga G.P.
Zem L.G.
Cordeiro-Fonseca V.
de Mesquita Tauil R.
Atanasov B.
Belev N.
Kovachev N.
Meléndez L.J.J.
Dimova A.
Dimov S.
Zelić Z.
Augustin G.
Bogdanić B.
Morić T.
Chouillard E.
Bajul M.
De Simone B.
Panis Y.
Esposito F.
Notarnicola M.
Lauka L.
Fabbri A.
Hentati H.
Fnaiech I.
Aurélien 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 D.K.
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.
Author's Affiliation
University General Hospital of Patras
Faculty of Health Sciences
Ospedale Guglielmo da Saliceto
College of Medicine and Health Sciences United Arab Emirates University
Zabok General Hospital
Evagelismos Hospital
Hôpital Américain de Paris
KBC Zagreb
Medical University of Plovdiv
Aretaio Hospital
Universidade Estadual de Campinas
National and Kapodistrian University of Athens
Tzanion General Hospital
Hôpital Henri Mondor
AP-HP Assistance Publique - Hopitaux de Paris
Centre Hospitalier Intercommunal Poissy-St-Germain-en-Laye
Singapore General Hospital
Attikon University Hospital
Athens Naval Hospital
Larissa General Hospital
Medizinische Universität Wien
Heraklion University Hospital
CHU Angers
Instituto Universitario del Hospital Italiano de Buenos Aires
Medizinische Universitat Innsbruck
Hippokration General Hospital
General Hospital of Kavala
Villeneuve St Georges Academic Hospital
Groupe Hospitalier Privé Ambroise Paré-Hartmann
Bioclinic Hospital Athens
Hospital Rafael Ángel Calderón Guardia
University Center Padre Albino (UNIFIPA)
Grupo Surgical
Hospital ViValle
U.O. Chirurgia Generale
Hospital Universitário Terezinha de Jesus
Agios Savvas Anticancer Hospital of Athens
Kipshidze Central University Hospital
Hopital Leon Binet
Maggiore Hospital
Faculty of Health Sciences
Ospedale Guglielmo da Saliceto
College of Medicine and Health Sciences United Arab Emirates University
Zabok General Hospital
Evagelismos Hospital
Hôpital Américain de Paris
KBC Zagreb
Medical University of Plovdiv
Aretaio Hospital
Universidade Estadual de Campinas
National and Kapodistrian University of Athens
Tzanion General Hospital
Hôpital Henri Mondor
AP-HP Assistance Publique - Hopitaux de Paris
Centre Hospitalier Intercommunal Poissy-St-Germain-en-Laye
Singapore General Hospital
Attikon University Hospital
Athens Naval Hospital
Larissa General Hospital
Medizinische Universität Wien
Heraklion University Hospital
CHU Angers
Instituto Universitario del Hospital Italiano de Buenos Aires
Medizinische Universitat Innsbruck
Hippokration General Hospital
General Hospital of Kavala
Villeneuve St Georges Academic Hospital
Groupe Hospitalier Privé Ambroise Paré-Hartmann
Bioclinic Hospital Athens
Hospital Rafael Ángel Calderón Guardia
University Center Padre Albino (UNIFIPA)
Grupo Surgical
Hospital ViValle
U.O. Chirurgia Generale
Hospital Universitário Terezinha de Jesus
Agios Savvas Anticancer Hospital of Athens
Kipshidze Central University Hospital
Hopital Leon Binet
Maggiore Hospital
Corresponding Author(s)
Other Contributor(s)
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.