ArticleLangenbeck's archives of surgery2024
Prevalence and outcomes of Hartmann's reversal following Hartmann's procedure in a regional center, a retrospective cohort study.
Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Hartmann's procedure reversal rate and short-term outcomes: a single centre retrospective cohort study.BMC surgery · 2026Article
- Reversal of Hartmann's procedure: The impact of timing - a single-tertiary-center experience.Surgery in practice and science · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHartmann's procedure (sigmoid resection with end colostomy) is a commonly performed emergency procedure for diseases of the sigmoid colon.
aimTo determine the proportion of patients undergoing Hartmann's reversal (restoration of GI continuity) following Hartmann's procedure, the clinical and demographic factors associated with reversal, and the reasons for non-reversal.
methodThis is a single center, retrospective audit of patients undergoing Hartmann's procedure between June 2011 and May 2020. Age, sex, American Society of Anesthesiologists classification (ASA), indication for Hartmann's, surgical approach, specialty of responsible surgeon (General or Colorectal), 30-day reoperation, requirement for radiologically-guided drain, and reason for non-reversal were recorded. The association between these factors and reversal was determined with Fischer's exact test and logistic regression. Cumulative reversal proportions were calculated with the Kaplan-Meier method.
resultsData was obtained for 114/117 patients, of whom 31% (35/114) underwent Hartmann's reversal. The median (IQR) time to reversal was 372 (188-500) days. Patients with restoration of GI continuity were younger (median 67 versus 73 years, P < 0.001) with fewer co-morbidities, (ASA ≤ 2 34% versus 9% P = 0.002). The estimated cumulative 24-month reversal incidence was 37%. Patients who had a Hartmann's procedure performed for diverticulitis had an increased odds of being reversed (OR 4.1 (95% CI 1.6, 10.5) P = 0.001); Hartmann's for malignancy was associated with decreased odds of reversal (OR 0.37 (95% CI 0.12, 1) P = 0.035).
conclusionOf patients who underwent Hartmann's procedure, the majority retained a permanent stoma. Older patients, those with high ASA, and those who underwent index procedures for malignancy had lower rates of reversal.
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