Is Closure of Hartmann’s Colostomy a Safe Operation?

• Published in: Turkish journal of colorectal disease Vol. 31; no. 4; pp. 309 - 315
• Main Authors: Şahin, Samet, Yılmaz, Eyüp Murat, Kırnap, Mahir, Yıldız, Buse, Bilgiç, Ethem, Demirkıran, Ahmet Ender
• Format: Journal Article
• Language: English; Turkish
• Published: Mersin Galenos Publishing House 01-12-2021
• Subjects: Intensive care; Ostomy
• ISSN: 2536-4898; 2536-4901
• DOI: 10.4274/tjcd.galenos.2021.2021-2-5

Aim: Ostomy closure after Hartmann’s procedure is a challenging decision for surgeons due to the frequency of postoperative early complications in these patients. The aim of this study was to evaluate whether this operation is safe and to identify the factors associated with complications, based on analysis of a population that underwent Hartmann’s procedure. Method: Ostomy closure patients, operated between January 2016 and December 2020, were included in the study retrospectively. Post-operative complications of the patients were classified by Modified Clavien Dindo (MCD) score. Results: During the study period 52 patients were eligible for inclusion. Seven (13.5%) had MCD high grade complication. Univariate analysis indicated a significant association between complication and first operation indication and between intensive care unit admission and first operation reason and also the MCD score. In regression analysis, it was found that an increase in age increased the need for intensive care (odds ratio: 1.046, 95% confidence interval: 1.004-1.089, p=0.032). Moreover, the reason for performing the Hartmann’s procedure in the first operation was determined as an independent risk factor for complication development and for intensive care (p=0.001 and p=0.028, respectively). Conclusion: Operation of Hartmann’s closure is a safe procedure in selected and experienced centres.