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Feasibility and morbidity of reversal of Hartmann's
Author(s) -
Banerjee S.,
Leather A. J. M.,
Rennie J. A.,
Samano N.,
Gonzalez J. G.,
Papagrigoriadis S.
Publication year - 2005
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2005.00862.x
Subject(s) - medicine , logistic regression , surgery , univariate analysis , comorbidity , complication , anastomosis , retrospective cohort study , multivariate analysis
Objective Reversal of Hartmann's is a major surgical procedure and associated with substantial morbidity and mortality. Method This study retrospectively analysed the data at a single centre over an eight‐year period to assess the clinical results and morbidity of reversal of Hartmann's. Results One hundred and ten Hartmann's procedures were performed during the period. Only 66 (61%) of patients had a reversal. Advanced age and comorbidity were the primary reasons for not reversing. Complications among the 66 patients (36 males and 30 females) who underwent reversal occurred in 26 (41%). There were no deaths. Patients who underwent reversal were ASA 2 (60%), ASA 3 (25%) and ASA 4 (4.6%). Univariate analysis demonstrated a significant association between complications following reversal and ASA grade ( P =0.01), and hypertension ( P = 0.03) There was no correlation between the patient variables and anastomotic leakage. Multiple logistic regression analysis showed a significant influence of hypertension, smoking and ASA grade on complications. Conclusions About 40% of patients who undergo Hartmann's procedure will not have a reversal. Reversal is a feasible operation for selected patients, but there is a high complication rate.