Evidence map›Paper›PMID 40611951›Full record

ArticleSurgery in practice and science2025

Reversal of Hartmann's procedure: The impact of timing - a single-tertiary-center experience.

Sascha Vaghiri, Maria Chara Stylianidi, Laura Engelmann, Eslam Elmaghraby, Levent Dizdar, Wolfram Trudo Knoefel, Hermann Kessler, Dimitrios Prassas

Abstract read
In one paragraph

Article in Surgery in practice and science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sascha VaghiriDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Duesseldorf, Germany.
Maria Chara StylianidiDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Duesseldorf, Germany.
Laura EngelmannMedical Research School Duesseldorf, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany.
Eslam ElmaghrabyDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Duesseldorf, Germany.
Levent DizdarDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Duesseldorf, Germany.
Wolfram Trudo KnoefelDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Duesseldorf, Germany.
Hermann KesslerDepartment of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Dimitrios PrassasDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Duesseldorf, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The optimal timing for Hartmann's reversal remains a topic of ongoing debate. This study aimed to assess postoperative outcomes in patients undergoing early versus late Hartmann's reversal at a tertiary academic center in Germany. Methods: A single-center retrospective cohort study was conducted, including all patients who underwent Hartmann's reversal between January 2008 and July 2020. Patients were stratified into early (ER) and late (LR) reversal groups using a median cut-off value of 159 days. Operative outcomes including major morbidity and overall postoperative complications were compared between both groups. Factors associated with major postoperative morbidity were detected using uni- and multivariate regression models. Results: A total of 133 patients classified into the ER (n = 67, 50.38%) and LR (n = 66, 49.62%) groups were analyzed. There were no significant differences in overall morbidity (ER 56.72% versus LR 39.39%, p = 0.057) and major morbidity rates (Clavien-Dindo ≥ IIIa) (ER 28.36% versus LR 21.21%, p = 0.423) between both groups. On multivariate analysis, smoking (p = 0.006), chronic renal disease (p = 0.003) and anastomotic configuration (p = 0.003) were identified as significant factors contributing to major morbidity after Hartmann's reversal. Conclusion: Hartmann's reversal is still associated with an increased risk of postoperative complications. However, timing of Hartmann's reversal does not seem to influence postoperative morbidity. Of note, patient-related modifiable factors as well as the anastomotic configuration are important determinants of major complication occurrence.

Indexed as

Hartmann’s reversal · Timing · Colorectal surgery · Morbidity

Identifiers

PMID40611951
PMCPMC12221653

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.