Hartmann's reversal is associated with worse outcomes compared to elective left colectomy: A NSQIP analysis of 36,794 cases

Yosef Nasseri, Andy Liu, Eli Kasheri, Kimberly Oka, Sean Langenfeld, Abbas Smiley, Jason Cohen, Joshua Ellenhorn, Moshe Barnajian

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Hartmann's reversal (HR) is associated with significant technical difficulty and morbidity. Using the ACS-NSQIP database, we assessed the outcomes of HR as compared to elective left colectomy (LC). Methods: The 2016–2019 ACS-NSQIP datasets were queried to identify patients undergoing HR and elective LC. Patients’ demographics, comorbidities, and short-term surgical outcomes were evaluated using both univariable and multivariable methods. Results: The study included 7,632 HR cases and 29,162 LC cases. The HR group had more patients with ASA grade III (50% vs. 42.4%). HR had more open-operative cases (69.4 vs. 18.5%) and longer mean operative times (213 vs. 191 min) than LC. Postoperatively, the HR group had a longer mean hospital stay (5.5 vs. 4.1 days) and higher complication rate (18.3% vs. 10.3%). HR was associated with increased odds of having a concurrent ileostomy (OR 2.11), deep space/organ infection (OR 1.55), and at least one complication (OR 1.56). Conclusion: HR is a more challenging operation with patients who fared worse than their LC counterparts. Consideration should be given to alternatives of the index Hartmann's procedure.

Original languageEnglish (US)
Pages (from-to)1351-1355
Number of pages5
JournalAmerican journal of surgery
Volume224
Issue number6
DOIs
StatePublished - Dec 2022

Keywords

  • Colorectal
  • Elective left colectomy
  • Hartmann's reversal
  • Surgical complexity
  • Surgical outcomes

ASJC Scopus subject areas

  • Surgery

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