{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:09:20Z","timestamp":1787170160399,"version":"build-2736575974"},"reference-count":10,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Hartmann\u2019s procedure is commonly employed to manage complications of acute sigmoid diverticulitis, such as perforation or abscess formation. However, determining the optimal timing for colostomy reversal remains a topic of debate. This study aims to evaluate the effect of early versus delayed colostomy reversal on postoperative outcomes, focusing on complications, hospital stay duration, and readmission rates. Methods: A retrospective cohort study was conducted on 148 patients who underwent Hartmann\u2019s procedure for acute sigmoid diverticulitis at a single tertiary care center between 2014 and 2023. Participants were grouped based on the timing of colostomy reversal: early (45\u2013120 days), intermediate (121\u2013180 days), and late (&gt;180 days). Data on complications, hospital stay length, and readmissions were analyzed. Results: Early reversal was associated with fewer postoperative complications, shorter hospital stays, and reduced readmissions compared to delayed reversal. The late reversal group had higher rates of complications, longer hospital stays, and a higher need for reintervention. Advanced age and comorbidities, such as cardiovascular disease and diabetes, were significant predictors of poor outcomes, contributing to delayed reversal. Logistic regression analysis indicated that late reversal was independently associated with higher complication rates. Conclusions: Early colostomy reversal within 45\u2013120 days following Hartmann\u2019s procedure is associated with improved postoperative outcomes, including fewer complications and a shorter hospital stay. The timing of colostomy reversal should be individualized based on patient health status, with early reversal preferred for those without significant comorbidities. Further prospective research is needed to confirm these findings and refine guidelines for optimal reversal timing.<\/jats:p>","DOI":"10.3390\/diseases13030072","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T08:05:54Z","timestamp":1740729954000},"page":"72","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Optimal Timing of Colostomy Reversal Following Hartmann\u2019s Procedure: A Retrospective Analysis of Postoperative Outcomes"],"prefix":"10.3390","volume":"13","author":[{"given":"Constantin","family":"Popazu","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Gala\u021bi, 800201 Gala\u021bi, Romania"},{"name":"County Emergency Clinical Hospital of Br\u0103ila, 810325 Br\u0103ila, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drago\u0219","family":"Voicu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Gala\u021bi, 800201 Gala\u021bi, Romania"},{"name":"County Emergency Clinical Hospital of Br\u0103ila, 810325 Br\u0103ila, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorel","family":"Firescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Gala\u021bi, 800201 Gala\u021bi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3627-0486","authenticated-orcid":false,"given":"Ionica","family":"Grigore","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Gala\u021bi, 800201 Gala\u021bi, Romania"},{"name":"County Emergency Clinical Hospital of Br\u0103ila, 810325 Br\u0103ila, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Toma","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, \u201cDun\u0103rea de Jos\u201d University of Gala\u021bi, 800201 Gala\u021bi, Romania"},{"name":"County Emergency Clinical Hospital of Br\u0103ila, 810325 Br\u0103ila, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9357-5230","authenticated-orcid":false,"given":"R\u0103zvan Petru","family":"Derihaci","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, TU Dresden, 01307 Dresden, Germany"},{"name":"National Center for Tumor Diseases, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","first-page":"4229","article-title":"Utilization and outcomes of Hartmann\u2019s procedure in emergency left colon surgery: Evaluating postoperative complications and stoma reversal rates","volume":"28","author":"Gurluler","year":"2024","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jviscsurg.2020.01.005","article-title":"Timing of colostomy reversal following Hartmann\u2019s procedure for perforated diverticulitis","volume":"157","author":"Horesh","year":"2020","journal-title":"J. Visc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1308\/rcsann.2018.0006","article-title":"Hartmann\u2019s procedure, reversal and rate of stoma-free survival","volume":"100","author":"Hallam","year":"2018","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Clementi, M., Pietroletti, R., Carletti, F., and Sista, F. (2022). Colostomy reversal after Hartmann\u2019s procedure: The importance of timing in short- and long-term complications. J. Clin. Med., 11.","DOI":"10.3390\/jcm11154388"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1001\/jamasurg.2018.4359","article-title":"Association of timing of colostomy reversal with outcomes following Hartmann procedure for diverticulitis","volume":"154","author":"Resio","year":"2019","journal-title":"JAMA Surg."},{"key":"ref_6","first-page":"2768","article-title":"Early colostomy reversal after Hartmann\u2019s procedure reduces healthcare costs and improves outcomes","volume":"26","author":"Turner","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_7","first-page":"2285","article-title":"Late stoma reversal after Hartmann\u2019s procedure increases postoperative morbidity in high-risk patients","volume":"35","author":"Whitney","year":"2020","journal-title":"Int. J. Color. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.suronc.2012.10.003","article-title":"Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: A systematic review and meta-analysis","volume":"22","author":"Cirocchi","year":"2013","journal-title":"Surg. Oncol."},{"key":"ref_9","first-page":"527","article-title":"Colostomy reversal following Hartmann\u2019s procedure: Factors predicting surgical outcomes and complications","volume":"23","author":"Kartal","year":"2019","journal-title":"Tech. Coloproctol."},{"key":"ref_10","first-page":"611","article-title":"Timing of colostomy reversal after Hartmann\u2019s procedure: Impact on recovery, readmissions, and healthcare costs","volume":"26","author":"Edomskis","year":"2022","journal-title":"J. Gastrointest. Surg."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/3\/72\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:44:07Z","timestamp":1760028247000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/3\/72"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["diseases13030072"],"URL":"https:\/\/doi.org\/10.3390\/diseases13030072","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]}}}