{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:47:08Z","timestamp":1792363628309,"version":"4.4.0"},"reference-count":26,"publisher":"Royal College of Surgeons of England","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hartmann\u2019s procedure is a commonly performed operation for complicated left colon diverticulitis or malignancy. The timing for reversal of Hartmann\u2019s is not well defined as it is technically challenging and carries a high complication rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a retrospective audit of all patients who underwent Hartmann\u2019s procedure between 2008 and 2014. Reversal of Hartmann\u2019s rate, timing, American Society of Anesthesiologists grade, length of stay and complications (Clavien\u2013Dindo) including 30-day mortality were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hartmann\u2019s procedure (n = 228) indications were complicated diverticular disease 44% (n = 100), malignancy 32% (n = 74) and other causes 24%, (n = 56). Reversal of Hartmann\u2019s rate was 47% (n = 108). Median age of patients was 58 years (range 21\u201384 years), American Society of Anesthesiologists grade 2 (range 1\u20134), length of stay was eight days (range 2\u201342 days). Median time to reversal of Hartmann\u2019s was 11 months (range 4\u201396 months). The overall complication rate from reversal of Hartmann\u2019s was 21%; 3.7% had a major complication of IIIa or above including three anastomotic leaks and one deep wound dehiscence. Failure of reversal and permanent stoma was less than 1% (n = 2). Thirty-day mortality following Hartmann\u2019s procedure was 7% (n = 15). Where Hartmann\u2019s procedure wass not reversed, for 30% (n = 31) this was the patient\u2019s choice and 70% (n = 74) were either high risk or unfit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hartmann\u2019s procedure is reversed less frequently than thought and consented for. Only 46% of Hartmann\u2019s procedures were stoma free at the end of the audit period. The anastomotic complication rate of 1% is also low for reversal of Hartmann\u2019s procedure in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1308\/rcsann.2018.0006","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T05:18:30Z","timestamp":1519708710000},"page":"301-307","source":"Crossref","is-referenced-by-count":123,"title":["Hartmann\u2019s procedure, reversal and rate of stoma-free survival"],"prefix":"10.1308","volume":"100","author":[{"given":"S","family":"Hallam","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Good Hope Hospital, Sutton Coldfield, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BS","family":"Mothe","sequence":"additional","affiliation":[{"name":"Royal Liverpool Hospital, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RMR","family":"Tirumulaju","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Good Hope Hospital, Sutton Coldfield, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"bib1","unstructured":"Hartmann H. Nouveau proc\u00e9d\u00e9 d\u2019ablation des cancers de la partie terminale du colon pelvien. 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