[Morbi-mortality of Hartmann's reversal procedure].
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.
Takahashi-Monroy
Takeshi
T
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
Velasco
Liliana
L
Morales-Olivera
José Martín
JM
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods* / Q000401:mortality; D003108:Colonic Diseases / Q000453:epidemiology / Q000601:surgery; D003125:Colostomy / Q000379:methods*; D015897:Comorbidity; D004239:Diverticulitis, Colonic / Q000453:epidemiology / Q000601:surgery; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology