Classification of Hartmann’s procedure reversal complications according to the Clavien-Dindo System
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Abstract
BACKGROUND: 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.
OBJECTIVES: Our objective was to investigate the complications and morbidities associated with HP reversal.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.