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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 4/2018

01-06-2018 | ORIGINAL ARTICLE

Hartmann’s reversal after colonic perforation or anastomosis leakage, is it the same procedure? A retrospective study of 150 patients

Authors: Nathalie Chereau, Jeremie H. Lefevre, Najim Chafai, Thevy Hor, Clotilde Debove, Emmanuel Tiret, Yann Parc

Published in: Langenbeck's Archives of Surgery | Issue 4/2018

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Abstract

Purpose

The high morbidity rates reported might influence surgeons’ decisions of whether to perform Hartmann’s reversal (HR). Our aim was to report the results of HR after “primary” Hartmann’s procedure (HP) or in redo surgery for failed anastomosis.

Methods

All patients operated between 2007 and 2015 were included. Data and postoperative course were obtained from a review of medical records and databases.

Results

One hundred fifty patients (age 60, range (20–91) years, 62% male) were included. Eighty-six patients (57%) were ASA ≥ 2. HP was mostly performed for diverticulitis (29.3%) and anastomotic leakage (24%). HR was possible in 145(97%) patients including six with previous failed attempt. Overall morbidity was 22.7% including 11.7% severe complications (Dindo 3–4). Operative blood loss and Charlson comorbidity index were the only significant risk factor for postoperative pelvic complications (p = 0.03; p = 0.0002, respectively).

Conclusions

In a colorectal tertiary center, HR was feasible in 97% with a low morbidity and a 3.4% anastomotic leakage rate.
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Metadata
Title
Hartmann’s reversal after colonic perforation or anastomosis leakage, is it the same procedure? A retrospective study of 150 patients
Authors
Nathalie Chereau
Jeremie H. Lefevre
Najim Chafai
Thevy Hor
Clotilde Debove
Emmanuel Tiret
Yann Parc
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 4/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-018-1667-0

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