Annals of Coloproctology

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Short-term outcomes following emergency Hartmann procedure: a comparison between colorectal and noncolorectal surgeons: Jae Won Jo, Sung Chul Lee, Jung Wook Suh, Hwan Namgung, Dong-Guk Park; Ann Coloproctol. 2026;42(3):315-323. Published online June 16, 2026; DOI: https://doi.org/10.3393/ac.2025.01389.0198

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Abstract PDF: Purpose
Given the increasing staffing shortages that often necessitate noncolorectal surgeons performing emergency colorectal procedures, this study aims to evaluate the effect of surgeon subspecialty on short-term postoperative outcomes in patients undergoing emergency Hartmann procedure and whether strengthening residency training in Hartmann procedure could improve surgical outcomes.
Methods
This retrospective study included 141 patients who underwent emergency Hartmann procedure at a single tertiary center between January 2010 and December 2021. Patients were categorized into colorectal and noncolorectal groups. The clinical characteristics, operative details, and outcomes were compared. Complications were classified using the Clavien-Dindo classification. Logistic regression analysis was used to identify complications and mortality.
Results
The noncolorectal group showed higher age (75 years vs. 69 years, P=0.038), hypertension prevalence (58.4% vs. 40.4%, P=0.039), and physiological instability (C-reactive protein >6.0 mg/dL: 55.1% vs. 36.5%, P=0.034; lactate: 1.90 mmol/L vs. 0.80 mmol/L, P<0.001). Complications were lower in the colorectal group (68.5% vs. 36.5%, P<0.001), with fewer major complications (Clavien-Dindo grade ≥III, 51.7% vs. 15.4%). The colorectal group had a lower mortality rate (25.8% vs. 3.8%, P=0.001). In the multivariate analysis, surgery performed by noncolorectal surgeons remained a significant independent risk factor for complications (odds ratio [OR], 2.96; 95% confidence interval [CI], 1.27–6.89; P=0.012) and mortality (OR, 15.53; 95% CI, 2.11–114.18; P=0.006) even after adjusting for age, diagnosis, American Society of Anesthesiologists physical status, C-reactive protein levels, and time to surgery.
Conclusion
Emergency Hartmann procedure for acute conditions yielded better short-term outcomes when performed by colorectal surgeons. These findings suggest that surgeon subspecialty is a critical determinant of survival, independent of patient severity or surgical timing. Improving surgical residency training in Hartmann procedure may enhance outcomes when noncolorectal surgeons must perform it due to staffing constraints.

Benign diesease & IBD,Minimally invasive surgery

Laparoscopic Hartmann reversal: experiences from a developing country: Dung Anh Nguyen, Tuong-Anh Mai-Phan, Truc Thanh Thai, Hai Van Nguyen; Ann Coloproctol. 2022;38(4):297-300. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2020.00577.0082

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Purpose
Laparoscopic surgery is considered a promising approach for Hartmann reversal but is also a complicated major surgical procedure. We conducted a retrospective analysis at a city hospital in Vietnam to evaluate the treatment technique and outcomes of laparoscopic Hartmann reversal (LHR).
Methods
A colorectal surgery database in 5 years between 2015 and 2019 (1,175 cases in total) was retrieved to collect 35 consecutive patients undergoing LHR.
Results
The patients had a median age of 61 years old. The median operative time was 185 minutes. All the procedures were first attempted laparoscopically with a conversion rate of 20.0% (7 of 35 cases). There was no intraoperative complication. Postoperative mortality and morbidity were 0 and 11.4% (2 medical, 1 deep surgical site infection, and 1 anastomotic leak required reoperation) respectively. The median time to first bowel activity was 2.8 days and median length of hospital stay was 8 days.
Conclusion
When performed by skilled surgeons, LHR is a feasible and safe operation with acceptable morbidity rate.

Citations

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Hartmann’s procedure reversal rate and short-term outcomes: a single centre retrospective cohort study
Christopher C L Liao, Balakrisanan Saravanan, Fatima Ismail, Matthew Farmer, Vamsi R Velchuru
BMC Surgery.2026;[Epub] CrossRef
Reversión de procedimiento de Hartmann laparoscópica versus abierta: estudio de casos y controles con pareamiento por puntaje de propensión
J.C. Gomar-González, A. Nuñez-Venzor, F.E. Álvarez-Bautista, A. Zubillaga-Mares, I. Serrano-Trejo, M. Moreno-Portillo, M. Trejo-Avila
Revista de Gastroenterología de México.2026;[Epub] CrossRef
Surgical Outcomes of Open and Laparoscopic Hartmann Reversal: A Single-Center Comparative Study
Mu-Han Tsai, Ming-Jenn Chen, Khaa-Hoo Ong, Chih-Ying Lu, Chung-Han Ho, Hsuan-Yi Huang, Yu-Feng Tian, I-Ning Yang
Cureus.2024;[Epub] CrossRef

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