{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T22:00:18Z","timestamp":1772661618417,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T00:00:00Z","timestamp":1570579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to assess outcomes of Hartmann's reversal (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) after failure of previous colorectal anastomosis (<jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content>) or coloanal anastomosis (<jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients planned for <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> from 1997 to 2018 following the failure of previous <jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content> were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1997 to 2018, 45 <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>s were planned following failed <jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content> performed for rectal cancer (<jats:italic>n<\/jats:italic>\u00a0=\u00a019, 42%), diverticulitis (<jats:italic>n<\/jats:italic>\u00a0=\u00a016, 36%), colon cancer (<jats:italic>n<\/jats:italic>\u00a0=\u00a04, 9%), inflammatory bowel disease (<jats:italic>n<\/jats:italic>\u00a0=\u00a02, 4%) or other aetiologies (<jats:italic>n<\/jats:italic>\u00a0=\u00a04, 9%). In two (4%) patients, <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> could not be performed. <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> was performed in 43\/45 (96%) patients with stapled <jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a024, 53%), delayed handsewn <jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content> with colonic pull\u2010through (<jats:italic>n<\/jats:italic>\u00a0=\u00a011, 24%), standard handsewn <jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a06, 14%) or stapled ileal pouch\u2013anal anastomosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a02, 4%). One (2%) patient died postoperatively. Overall postoperative morbidity rate was 44%, including 27% of patients with severe postoperative complication (Clavien\u2013Dindo\u00a0\u2265\u00a03). After a mean follow\u2010up of 38\u00a0\u00b1\u00a030\u00a0months (range 1\u2013109), 35\/45 (78%) patients presented without stoma. Multivariate analysis identified a remnant rectal stump &lt;\u00a07.5\u00a0cm in length as the only independent risk factor for long\u2010term persistent stoma. Among stoma\u2010free patients, low anterior resection syndrome (<jats:styled-content style=\"fixed-case\">LARS<\/jats:styled-content>) score was \u2264\u00a020 (normal) in 43%, between 21 and 29 (minor <jats:styled-content style=\"fixed-case\">LARS<\/jats:styled-content>) in 33% and \u2265\u00a030 (major <jats:styled-content style=\"fixed-case\">LARS<\/jats:styled-content>) in 24% of the patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> can be recommended in patients following a failed <jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content>. It permits 78% of patients to be free of stoma. A short length of the remnant rectal stump is the only predictive factor of persistent stoma in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14854","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T18:18:35Z","timestamp":1568917115000},"page":"203-211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Reversal of Hartmann's procedure in patients following failed colorectal or coloanal anastomosis: an analysis of 45 consecutive cases"],"prefix":"10.1111","volume":"22","author":[{"given":"C.","family":"Caille","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Assistance Publique \u2013 H\u00f4pitaux de Paris (AP\u2010HP) Beaujon Hospital University Denis Diderot (Paris VII) Clichy 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