Classification of Hartmann’s procedure reversal complications according to the Clavien-Dindo System
Adnan Hut 1, Okan Murat Aktürk 1, Mikail Çakır 1
Affiliations
Article Info
1 University of Health Sciences Istanbul Hamidiye Vocational School of Medical Sciences, Turkey
2 Department of Surgery, University of Health Sciences, Istanbul Haseki Training and Research Hospital, Turkey
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.
Keywords
- Complications
- Colostomy
- Clavien-Dindo classification
- Hartmann’s procedure reversal
- Hartmann’s system procedure reversal
