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Am J Surg ; 218(5): 918-927, 2019 11.
Article in English | MEDLINE | ID: mdl-30853093

ABSTRACT

BACKGROUND: Aim of the study was to describe characteristics and outcomes of Hartmann's procedure (HP) and subsequent intestinal restoration. METHODS: Retrospective study including all patients who underwent HP over a period of 16 consecutive years. We propose a classification and regression tree for a more accurate view of the relationship between the variables related to intestinal restoration and their weighting in the decision to reverse HP. RESULTS: 533 patients were included. Overall morbidity rate of HP was 53.5% and mortality 21.0%. Overall morbidity of the intestinal continuity reconstruction was 47.3% and mortality 0.9%. Patients with a benign disease, aged under 69 years and with low comorbidity, had an 84.4% probability of undergoing intestinal reconstruction. CONCLUSIONS: HP is associated with high morbidity and mortality. Restoration of intestinal continuity involves minor, but frequent, morbidity and a low mortality rate. Age and comorbidities can decrease, and even override, the decision to reverse HP.


Subject(s)
Colon, Descending/surgery , Colon, Sigmoid/surgery , Colonic Diseases/surgery , Rectum/surgery , Aged , Aged, 80 and over , Anastomosis, Surgical , Colectomy/adverse effects , Colectomy/methods , Colostomy/adverse effects , Colostomy/methods , Female , Humans , Longitudinal Studies , Male , Middle Aged , Proctectomy/adverse effects , Proctectomy/methods , Retrospective Studies , Treatment Outcome
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