Features of Complication after Reversal of Hartmann’s Operation

Features of Complication after Reversal of Hartmann’s Operation: Retrospective Analysis of 70 Patients

Hartmann’s procedure is most often used if immediate anastomosis is not feasible and considered very high risk of anastomotic leakage. The reversal of Hartmann operation has a significant benefit in patient s quality of life, but there are disadvantages because it is procedure of a high degree of complexity. For reversal of Hartmann operation to be truly beneficial, morbidity rate should be reasonable. The aim of this study is therefore to review clinical outcomes of the conversion of Hartmann procedure and define the complication rate of reversal of Hartmann operation in a contemporary practice. Patients undergoing an elective reversal of Hartmann’s procedure at Chosun University Hospital between January 2011 and December 2016 were included in our analysis, and the medical records were retrospectively reviewed. Total 70 patients underwent Hartmann reversal during this period. There were 33 men (47.1%) and the mean age was 67.7±14.5. The most frequent indications for Hartmann’s procedure were complicated diverticulitis in 37 patients (52.9%). Major morbidity rate was 14.3% (10 patients), anastomotic leakage rate of 4.3% and mortality rate was 2.9% (2 patients). The most common complication was wound infection (25.7%). Univariate analysis demonstrated that there were no statistically significant variables. This study demonstrates that patients who underwent reversal of their Hartmann’s operation did not have increased postoperative morbidity based on advanced age, higher ASA score, presence of multiple comorbidities, type of operation, and longer operation time.