Hartmann’s procedure vs primary anastomosis: patient-centered outcomes in older adults

Abstract

Diverticulitis in older adults often requires surgical intervention, with Hartmann’s procedure (HP) and primary anastomosis with proximal diversion (PAPD) being commonly performed approaches. Patient-centered outcomes, including days alive and at home (DAAH) and non-home discharge, are increasingly recognized as crucial metrics. Recent retrospective analyses indicate no significant differences in DAAH or non-home discharge between HP and PAPD, even in urgent or emergent admissions. Postoperative complications, rather than surgical strategy, predominantly influence recovery. These findings underscore that both procedures are safe and feasible for older adults, allowing individualized decision-making based on patient condition and surgeon expertise. Future studies integrating frailty and patient-reported outcomes are warranted to optimize surgical care in this population.