Hartmann reversal: obesity adversely impacts outcome

Area of Science:

• Colorectal Surgery
• Surgical Outcomes Research

Background:

• Postoperative complications after Hartmann reversal lack comprehensive predictive analysis.
• Identifying predictors of morbidity is essential for patient management.

Purpose of the Study:

• To identify factors predicting morbidity following Hartmann reversal.
• To analyze the impact of patient and procedural variables on postoperative outcomes.

Main Methods:

• Retrospective review of prospectively collected data from January 2004 to July 2011.
• Inclusion of consecutive patients undergoing Hartmann reversal.
• Univariate and multivariate analyses to determine predictors of complications.

Main Results:

• Overall morbidity was 46% in 95 patients.
• Prophylactic ureteral stents and open surgical approach were associated with higher complication rates.
• Independent predictors of morbidity included body mass index (BMI), prior Hartmann procedure hospital stay, and short distal stump length.
• Obesity was linked to increased overall morbidity, wound infections, and need for diverting ileostomy.

Conclusions:

• Hartmann reversal is associated with substantial morbidity.
• Body mass index (BMI) is an independent predictor of postoperative complications.
• Obese patients may benefit from weight loss interventions prior to Hartmann reversal.