HARTMANN’S SIGMOIDECTOMY IN THE TREATMENT OF COMPLICATED DIVERTICULITIS: INDICATIONS, APPLICABILITY, AND CLINICAL OUTCOMES

Abstract

Complicated diverticulitis is a severe clinical condition frequently associated with complications such as abscess formation, perforation, and diffuse peritonitis, often requiring urgent surgical intervention. This study aimed to analyze the indications, applicability, and clinical outcomes of Hartmann’s procedure in the management of this condition. This is an integrative literature review conducted through a systematic search in PubMed/MEDLINE, Scopus, Web of Science, and the Virtual Health Library, including studies published between 2020 and 2026. Study selection followed predefined inclusion and exclusion criteria, with careful data extraction and analysis. The findings demonstrated that Hartmann’s procedure remains widely indicated in cases of hemodynamic instability and severe sepsis due to its safety in controlling intra-abdominal infection. However, it is associated with high morbidity, prolonged hospital stay, and low rates of stoma reversal. In contrast, primary anastomosis has shown comparable mortality outcomes, with advantages in long-term results, particularly regarding intestinal continuity restoration. It is concluded that the choice of surgical approach should be individualized, taking into account clinical, surgical, and institutional factors, aiming to balance immediate safety with long-term quality of life.