Classification of Hartmann's procedure reversal complications according to the Clavien-Dindo System

Hartmann's Procedure (HP) is performed for cancer, trauma or benign diseases of the left colon. It is regarded as a solution to avoid a risky anastomosis with the intent to reverse after the diseased colon is given time to recover. This reversal has been associated with a potential morbidity and mortality.

Our objective was to investigate the complications and morbidities associated with HP reversal.

The Hartmann reversal operations performed in the general surgery department were reviewed between January 2014 and January 2018 in the Istanbul Haseki Training and Research Hospital.

During the evaluation period, 41 patients underwent a HP reversal with the mean age of 57.45 ± 15.75 The majority of the patients were male (73%; n = 30). The overall complication rate was 44%. There were seven (17%) cases of reoperation with high-grade complications, and four (9.8%) of the patients were re-hospitalized due to complications.

HP reversal can be considered a relatively safe operation for a selected group of patients including those with preoperative comorbidities, yielding an anastomotic leakage rate of 7.3% and a hospital readmission rate of less than 10%. The repair of an incisional hernia at the same time does not increase the complication rate.

Complications, Colostomy, Clavien-Dindo classification, Hartmann's procedure reversal, Hartmann's system procedure reversal.