A comparison of complications associated with colostomy reversal versus ileostomy reversal.
BACKGROUND
The incidence of complications after reversal of Hartmann's procedure is unknown. This study compares the morbidity of Hartmann's reversal versus loop ileostomy reversal.


METHODS
Two groups of 20 patients were studied retrospectively over a 5-year period. One group underwent Hartmann's takedown, and the other underwent loop ileostomy takedown. Postoperative complications were compared between the 2 groups.


RESULTS
Similar demographics were noted between each group. The most common initial indications for Hartmann's procedure were diverticulosis (11 patients, 55%) and colon cancer (4 patients, 20%). For patients who had undergone colectomy with primary anastomosis and ileostomy, colon cancer was the most common indication (12 patients, 60%) followed by diverticulosis (3 patients, 15%). Complications were more common after Hartmann reversal than loop ileostomy reversal (16 complications/11 patients versus 6 complications/4 patients, P = .047).


CONCLUSIONS
Segmental colonic excision with anastomosis and loop ileostomy may be an attractive alternative to minimize morbidity with stoma reversal.
Bell
Christopher
C
Surgical Service, Dallas VA Medical Center, MC 112, 4500 Lancaster Road, Dallas, TX 75216, USA.
Asolati
Massimo
M
Hamilton
Elizabeth
E
Fleming
Jason
J
Nwariaku
Fiemu
F
Sarosi
George
G
Anthony
Thomas
T
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects* / Q000379:methods; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome