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. 2015 Oct-Dec;8(4):488-91.

Morbidity after reversal of Hartmann operation: retrospective analysis of 56 patients

E C Zarnescu Vasiliu  1 , N O Zarnescu  2 , R Costea  2 , L Rahau  3 , S Neagu  2
Affiliations

Morbidity after reversal of Hartmann operation: retrospective analysis of 56 patients

E C Zarnescu Vasiliu et al. J Med Life. 2015 Oct-Dec.

Abstract

Background: Despite patient selection, postoperative morbidity after reversal of Hartmann's procedure remains significant.

Aim: The objective of this study was to investigate risk factors associated with morbidity after conversion of Hartmann's operation.

Patients and methods: We retrospectively analyzed data of 56 patients who underwent reversal procedures between January 2004 and May 2015 in a single center. We evaluated the following variables: demographic characteristics, medical comorbidities, etiology for Hartmann operation, preoperative lab values, intraoperative surgical details and short-term outcomes (hospital stay, medical and surgical complications, mortality).

Results: There were 37 men (66.1%) and the mean age was 57 years. The most frequent indications for Hartmann's procedure were colorectal cancer in 25 patients (44.6%) and complicated diverticulitis in 10 patients (17.9%). The mean time to the reversal procedure was 9 months. Morbidity rate was 16.1% (9 patients) with an anastomotic leakage rate of 3.6% (2 patients) and mortality rate was 3.6% (2 patients). The most common medical complication was diarrhea (4 patients, 7.2%). Bivariate analysis demonstrated that the only factor significantly associated with postoperative complications was presence of multiple comorbidities.

Conclusions: Multiple medical comorbidities is the only predictive factor for postoperative complications after Hartmann's reversal and therefore patient selection for this type of surgery is critical.

Keywords: Hartmann’s reversal; anastomotic fistula; anastomotic leakage; colostomy closure; morbidity.

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