Hartmann's Reversal: A Single-Centre Experience.

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Hartmann's procedure (HP) is a surgical option for rectosigmoid colon issues.
• HP involves resecting the rectosigmoid colon, creating a colostomy, and closing the rectal stump.
• Reversal of HP is often planned but not always feasible.

Purpose of the Study:

• To identify predictive factors for Hartmann's procedure stoma reversal.
• To assess intraoperative difficulties influencing the decision for stoma reversal.
• To analyze indications and contraindications for Hartmann's procedure reversal.

Main Methods:

• Retrospective analysis of patients undergoing Hartmann's procedure (HP) from 2010-2017.
• Evaluation of preoperative, intraoperative, and postoperative data.
• Inclusion of patients with both benign and malignant conditions.

Main Results:

• Reversal rates correlate with benign diagnoses, particularly diverticular disease.
• Contraindications for reversal include disease progression/metastasis, advanced age, and comorbidities.
• Intraoperative factors like 'frozen pelvis' or leaks also contraindicate reversal.

Conclusions:

• Predictive factors and intraoperative challenges significantly impact Hartmann's procedure reversal decisions.
• Disease characteristics and patient factors are crucial in planning stoma reversal.
• Careful patient selection and surgical assessment are vital for successful Hartmann's procedure reversal.