Factors influencing postoperative adverse events after Hartmann's reversal.


Journal Article

AIM: The study was performed to evaluate factors influencing postoperative adverse events after Hartmann's reversal (HR). METHOD: This was a retrospective study of unselected patients who underwent HR after the Hartmann's procedure (HP) for left colonic perforation with peritonitis at a single institution. Data were retrieved from an Institutional Review Board-approved database. The study end-point was postoperative adverse events, which included mortality, complications, reoperations and 30-day readmission. Lag time was defined as the time from HP to HR. The results are expressed as mean±SD. RESULTS: From 1997 to 2007, 204 (39.1%) of all patients who underwent the HP [60±16 years of age; 58% men; body mass index (BMI) 27.6±5.7; 2% were American Society of Anesthesiology (ASA) 1, 50.2% were ASA 2, 39.9% were ASA 3 and 7.9% were ASA 4) underwent HR at an interval of 158±107 days. There were 24 laparoscopic and 180 open HRs, with no deaths. The operating time was 167±64 min, estimated blood loss was 245±283 ml and the 30-day readmission rate was 4.9%. Eleven (5.4%) patients developed 14 (6.8%) complications and five (2.4%) of these patients required a new stoma at the time of HR or later. On multivariate analysis controlling for confounders, chronic renal failure requiring dialysis (OR=21.0; 95% CI: 1.5-284; P=0.02) was significantly associated with increased adverse events. CONCLUSION: The study showed that chronic renal failure requiring dialysis was the only independent predictor of postoperative adverse event rates following HR.

Full Text

Duke Authors

Cited Authors

  • Okolica, D; Bishawi, M; Karas, JR; Reed, JF; Hussain, F; Bergamaschi, R

Published Date

  • March 2012

Published In

Volume / Issue

  • 14 / 3

Start / End Page

  • 369 - 373

PubMed ID

  • 21689318

Pubmed Central ID

  • 21689318

Electronic International Standard Serial Number (EISSN)

  • 1463-1318

International Standard Serial Number (ISSN)

  • 1462-8910

Digital Object Identifier (DOI)

  • 10.1111/j.1463-1318.2011.02629.x


  • eng