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[Intestinal reconstruction after a Hartmann intervention: a high-risk procedure?]
M Chiarugi1, P Buccianti, C Galatioto
1Dipartimento di Chirurgia, Università degli Studi di Pisa.
Annali Italiani Di Chirurgia
|April 24, 1999
Summary
Reversing Hartmann's procedure is safe, with a low rate of complications. Most issues, like anastomosis stenosis, resolve without surgery, making reversal a viable option.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Hartmann's procedure reversal is often considered high-risk.
- Previous reports indicate high rates of general and anastomosis-related complications.
Purpose of the Study:
- To evaluate the safety and morbidity of reversing Hartmann's procedure.
- To test the hypothesis that Hartmann's procedure reversal is a high-risk surgery.
Main Methods:
- Retrospective analysis of 40 patients undergoing Hartmann's reversal.
- Procedures included manual (10%) or stapled (90%) colorectal anastomosis.
- Mean interval to reversal was 259 days.
Main Results:
- No mortality was recorded.
- Overall complication rate was 37.5%, with wound infection being most common (9 patients).
- Anastomotic complications occurred in 12.5% (5 patients), including stenosis (10%) and bleeding (2.5%); no leaks were observed.
Conclusions:
- Restoration of bowel continuity after Hartmann's procedure is safe.
- Morbidity rates are acceptable, with most anastomotic complications resolving without further surgery.