I chose the above article as it pertained to one of the history and physicals I presented during a site evaluation. The patient experienced perforated diverticulitis and had undergone a Hartmann’s procedure, which was the choice procedure of the surgeon on the patients case. I remembered learning about other options for perforated diverticulitis and wanted to see what research showed regarding the two surgical treatments.
The article is a systematic review and meta-analysis of randomized control trials including patients undergoing surgical management of perforated diverticulitis with either primary anastomosis or a Hartmann’s procedure. The systematic review analyzed 254 patients with 116 in the primary anastomosis group and 138 in the Hartmann’s group. The study looked at primary outcomes of postoperative mortality and permanent stoma rate, and secondary outcomes of postoperative morbidity, stoma reversal, intra-abdominal abscess, and anastomotic leak. There was no significant difference in the rate of postoperative mortality or permanent stoma rate between the two procedures. Regarding secondary outcomes, there was no significant difference seen in postoperative morbidity. Patients in the primary anastomosis group had a 66% lower risk of intra-abdominal abscess while patient in the Hartmann’s procedure group had a lower rate of anastomotic leak. The study found that primary anastomosis and Hartmann’s procedure were equivalent regarding most outcomes.
This entry is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license.
