Hartmann's reversal: factors affecting complications and outcomes

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Patient Management

Background:

• Hartmann's procedure is often performed emergently for various conditions.
• Reversal of the colostomy after Hartmann's procedure is associated with significant morbidity.
• Guidance is needed for surgeons deciding on colostomy reversal.

Purpose of the Study:

• To identify factors associated with complications after Hartmann's reversal.
• To provide data to aid surgeons in the decision-making process for colostomy reversal.
• To analyze outcomes of Hartmann's reversal in a tertiary medical center.

Main Methods:

• Retrospective review of 249 patients undergoing Hartmann's reversal (May 2002 - October 2017).
• Analysis of patient characteristics and intra/postoperative complications.
• Statistical analysis using Chi-square and t-tests/Wilcoxon signed rank test.

Main Results:

• 31.8% of patients experienced major complications after reversal.
• Anastomotic leak occurred in 4% of patients.
• Higher complication rates were associated with ASA 4, liver disease, and BMI < 30.

Conclusions:

• Nearly one-third of patients face major complications after Hartmann's reversal.
• ASA 4, liver disease, and low BMI are risk factors for complications.
• Laparoscopic reversal showed no significant difference in outcomes compared to open procedures.