6533b828fe1ef96bd1287916

RESEARCH PRODUCT

Reversal of Hartmann's procedure: a single-centre experience of 533 consecutive cases.

E. Espín-basanyA. Royo-aznarV. Pla-martíStephanie García-botelloAlejandro Espí-macíasJosé Martín-arévaloDavid Moro-valdezate

subject

MaleReoperationmedicine.medical_specialtyMultivariate analysisRectumLogistic regression03 medical and health sciences0302 clinical medicineColon SigmoidmedicineHartmann's procedureHumansElective surgeryAgedRetrospective Studiesbusiness.industryRectal NeoplasmsAnastomosis SurgicalProctocolectomy RestorativeGastroenterologyRectumSigmoid colonRetrospective cohort studyMiddle AgedPrognosisSurgerySingle centremedicine.anatomical_structureLogistic ModelsTreatment Outcome030220 oncology & carcinogenesisMultivariate Analysis030211 gastroenterology & hepatologyFemalebusiness

description

AIM Hartmann's procedure (HP) is common. However, restoration of intestinal continuity is not so frequent. The aim of this study was to determine predictive factors which might influence outcomes following the reversal of HP. METHOD All consecutive patients who underwent elective and emergency HP in a single institution between January 1999 and December 2014 were included. Data concerning patient, disease and treatment features were collected. Univariate and multivariate binary logistic regression models were used to determine prognostic factors. RESULTS A total of 533 consecutive patients underwent HP over the 16-year period. Factors that were associated with a higher probability of reversal were age (< 69 years), American Society of Anesthesiologists (ASA) grade (I or II), indication for HP (likelihood of anastomotic leakage) and length of rectal stump reaching or exceeding the sacral promontory. A reduced probability of intestinal reconstruction was associated with anal incontinence, Stage IV cancer, postoperative transfusion or elective surgery. CONCLUSION Age, ASA grade, the indication for HP, the length of rectal stump, anal incontinence, tumour stage, postoperative transfusion and elective surgery determine the probability of reversal.

10.1111/codi.14049https://pubmed.ncbi.nlm.nih.gov/29430804