A retrospective study of all patients who underwent Hartmann\'s reversal from 2010 to 2020 within a tertiary referral centre in Melbourne, Australia. One hundred from a total of 406 (25%) who underwent an emergency Hartmann\'s procedure had a subsequent reversal. Complete patient data was available for 83 of these patients.
The average patient age was 60 years, and the median time for reversal was 14.0 (IQR 10-23) months. Seventy-nine of 83 (95%) reversals had a preoperative endoscopic evaluation of both their rectal stump and a complete colonoscopy. Stoma stenosis (n = 2), patient refusal (n = 1) and emergency reversal (n = 1) were cited reasons for not undergoing preoperative endoscopic evaluation. A third (n = 28, 34%) had a computed tomography prior to reversal; the majority was due to their underlying cancer surveillance (n = 21, 75%). Reversal was associated with a morbidity rate of 47% (n = 39). Surgical site infections (SSIs) (n = 21, 25%) were the most common type of complications encountered, with the majority being superficial (n = 15, 71%). SSIs were associated with steroid use (5/21 versus 4/62, p = 0.03) and greater hospital length of stay (6 versus 10 days, p = 0.03).
Only a quarter of emergency Hartmann\'s procedures within our institution were reversed. A significant proportion developed postoperative complications. Surgical site infection was the most common morbidity.
在墨尔本三级转诊中心,对2010年至2020年所有接受Hartmann逆转的患者进行了回顾性研究。
患者平均年龄为60岁,
我们机构内只有四分之一的Hartmann紧急程序被撤销。