Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure

Abstract Post operative ventral hernias are common following Hartmann's procedure. There is a debate whether hernia repair is safe when performed concomitantly with colostomy closure. In this study we aimed to evaluate the outcomes of synchronous Hartmann reversal (HR) with a hernia repair, com...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Y. Rudnicki, N. Horesh, Y. Lessing, V. Tverskov, A. Wachtel, M. Slavin, H. Tulchinsky, N. Wasserberg, E. Mavor, O. Zmora, S. Avital
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1a1668628fe84d3babee57d5fd93ebe8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:1a1668628fe84d3babee57d5fd93ebe8
record_format	dspace
spelling	oai:doaj.org-article:1a1668628fe84d3babee57d5fd93ebe82021-12-02T15:22:56ZSynchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure10.1038/s41598-021-81064-32045-2322https://doaj.org/article/1a1668628fe84d3babee57d5fd93ebe82021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81064-3https://doaj.org/toc/2045-2322Abstract Post operative ventral hernias are common following Hartmann's procedure. There is a debate whether hernia repair is safe when performed concomitantly with colostomy closure. In this study we aimed to evaluate the outcomes of synchronous Hartmann reversal (HR) with a hernia repair, compared to a staged procedure. A retrospective multi-center study was conducted, including all patients who underwent Hartmann’s procedure from January 2004 to July 2017 in 5 medical centers. Patient data included demographics, surgical data and post-operative outcome. Two hundred and seventy-four patients underwent colostomy reversal following Hartmann's procedure. In 107 patients (39%) a concomitant ventral hernia was reported during the Hartmann's reversal. Out of this cohort, 62 patients (58%) underwent hernia repair during follow-up. Thirty two patients (52%) underwent a synchronous hernia repair and 30 patients (48%) underwent hernia repair as a separate procedure. Post operative complication rate was significantly higher in the colostomy reversal with synchronous hernia repair group when compared to HR alone group (53% vs. 20%; p < 0.01; OR 4.5). In addition, severe complication rate (Clavien–Dindo score ≥ 3) was higher in the synchronous hernia repair group (25% vs. 7%). A tendency for higher hernia recurrence rate was noted in the synchronous group (56% vs. 40%). Median follow up time was 2.53 years (range 1–13.3 years). Synchronous colostomy closure and ventral hernia repair following Hartmann's procedure carries a significant risk for post operative complications, indicating that a staged procedure might be preferable.Y. RudnickiN. HoreshY. LessingV. TverskovA. WachtelM. SlavinH. TulchinskyN. WasserbergE. MavorO. ZmoraS. AvitalNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Y. Rudnicki N. Horesh Y. Lessing V. Tverskov A. Wachtel M. Slavin H. Tulchinsky N. Wasserberg E. Mavor O. Zmora S. Avital Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
description	Abstract Post operative ventral hernias are common following Hartmann's procedure. There is a debate whether hernia repair is safe when performed concomitantly with colostomy closure. In this study we aimed to evaluate the outcomes of synchronous Hartmann reversal (HR) with a hernia repair, compared to a staged procedure. A retrospective multi-center study was conducted, including all patients who underwent Hartmann’s procedure from January 2004 to July 2017 in 5 medical centers. Patient data included demographics, surgical data and post-operative outcome. Two hundred and seventy-four patients underwent colostomy reversal following Hartmann's procedure. In 107 patients (39%) a concomitant ventral hernia was reported during the Hartmann's reversal. Out of this cohort, 62 patients (58%) underwent hernia repair during follow-up. Thirty two patients (52%) underwent a synchronous hernia repair and 30 patients (48%) underwent hernia repair as a separate procedure. Post operative complication rate was significantly higher in the colostomy reversal with synchronous hernia repair group when compared to HR alone group (53% vs. 20%; p < 0.01; OR 4.5). In addition, severe complication rate (Clavien–Dindo score ≥ 3) was higher in the synchronous hernia repair group (25% vs. 7%). A tendency for higher hernia recurrence rate was noted in the synchronous group (56% vs. 40%). Median follow up time was 2.53 years (range 1–13.3 years). Synchronous colostomy closure and ventral hernia repair following Hartmann's procedure carries a significant risk for post operative complications, indicating that a staged procedure might be preferable.
format	article
author	Y. Rudnicki N. Horesh Y. Lessing V. Tverskov A. Wachtel M. Slavin H. Tulchinsky N. Wasserberg E. Mavor O. Zmora S. Avital
author_facet	Y. Rudnicki N. Horesh Y. Lessing V. Tverskov A. Wachtel M. Slavin H. Tulchinsky N. Wasserberg E. Mavor O. Zmora S. Avital
author_sort	Y. Rudnicki
title	Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
title_short	Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
title_full	Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
title_fullStr	Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
title_full_unstemmed	Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
title_sort	synchronous hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1a1668628fe84d3babee57d5fd93ebe8
work_keys_str_mv	AT yrudnicki synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT nhoresh synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT ylessing synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT vtverskov synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT awachtel synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT mslavin synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT htulchinsky synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT nwasserberg synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT emavor synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT ozmora synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure AT savital synchronoushartmannreversalandincisionalherniarepairisassociatedwithhighercomplicationratecomparedtoastagedprocedure
_version_	1718387371116855296

Synchronous Hartmann reversal and incisional hernia repair is associated with higher complication rate compared to a staged procedure

Ejemplares similares