Takeshi Takahashi-Monroy1, Liliana Velasco, José Martín Morales-Olivera. 1. Servicio de Cirugía de Colon y Recto, Departamento de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Deleg. Tlalpan, 14000 México, D.F., México. takahashit@infosel.net.mx
Abstract
BACKGROUND: Hartmann's operation is an alternative for emergency colorectal surgeries, but its reversal may be difficult and prone to complications. A longer interval for its reversal has been recommended to decrease complications. METHODS: In order to determine rates of morbi-mortality and to ascertain the association between the time interval for its reversal and presence of complications, we undertook a retrospective analysis of 48 patients with a mean age of 57 +/- 16 years. Nineteen patients (40%) were >65 years, and 21 (44%) had one or more underlying chronic disease. Perioperative factors associated with morbi-mortality were determined by means of the Mann-Whitney U test and Fisher exact test. RESULTS: Acute diverticulitis was the most frequent indication (42%). Mean interval between Hartmann's operation and its reversal was 8 months (range: 1 to 46 months). Mean duration of the reversal operation was 267 min (range: 120 to 540 min). There were complications in 29 patients (60%) including anastomotic leaks in 6 (12%) and operative deaths in 4 (8%). A shorter interval between Hartmann's operation and its reversal was not associated with more complications or longer surgical time. CONCLUSIONS: Hartmann's reversal operation has high rates of morbidity and mortality that are not influenced by the time interval from the original operation.
BACKGROUND: Hartmann's operation is an alternative for emergency colorectal surgeries, but its reversal may be difficult and prone to complications. A longer interval for its reversal has been recommended to decrease complications. METHODS: In order to determine rates of morbi-mortality and to ascertain the association between the time interval for its reversal and presence of complications, we undertook a retrospective analysis of 48 patients with a mean age of 57 +/- 16 years. Nineteen patients (40%) were >65 years, and 21 (44%) had one or more underlying chronic disease. Perioperative factors associated with morbi-mortality were determined by means of the Mann-Whitney U test and Fisher exact test. RESULTS: Acute diverticulitis was the most frequent indication (42%). Mean interval between Hartmann's operation and its reversal was 8 months (range: 1 to 46 months). Mean duration of the reversal operation was 267 min (range: 120 to 540 min). There were complications in 29 patients (60%) including anastomotic leaks in 6 (12%) and operative deaths in 4 (8%). A shorter interval between Hartmann's operation and its reversal was not associated with more complications or longer surgical time. CONCLUSIONS: Hartmann's reversal operation has high rates of morbidity and mortality that are not influenced by the time interval from the original operation.
Authors: Eveline Patteet; Sander Van Hoof; Tom Hendrickx; Sylvie Van den Broeck; Guy Hubens; Niels Komen Journal: Int J Colorectal Dis Date: 2022-01-29 Impact factor: 2.571