Hartmann's Reversal Is Associated With High Postoperative Adverse Events

PURPOSE: METHODS: RESULTS:Hartmann's reversal was associated with a higher prevalence of surgical or medical complications compared with primary resection and anastomosis (43.8 percent and 9.1 percent for Hartmann's reversal vs. 26.0 percent and 4.8 percent for primary resection and anastomosis). There was no difference in the readmission rates (7.2 percent vs. 7.6 percent, respectively, P = 0.88) or early postoperative mortality (1.7 percent vs. 0.7 percent, P = 0.25) between Hartmann's reversal and primary resection and anastomosis. The need for reoperation, prolonged ileus, respiratory tract infections, and renal failure were more common adverse events in the Hartmann's reversal group (P < 0.01). Having controlled for the number of comorbid conditions, extent of diverticular disease, severity of peritoneal contamination (Mannheim Peritonitis Index), and operative urgency, patients who underwent Hartmann's reversal were 2.1 times more likely to have adverse surgical events during their postoperative period (95 percent confidence interval for odds ratio = 1.3-3.3). CONCLUSIONS: