THE STOMA REVERSAL AFTER HARTMANN PROCEDURE IN PATIENTS WITH COLORECTAL CANCER OPERATED IN EMERGENCY

Georgiana Bianca  Constantin; D.  Firescu; D.  Voicu; B.  Ștefănescu; R.  Mihailov; Cristina  Șerban; Rodica  Bîrlă; S.  Constantinoiu

doi:10.33695/rojes.v2i1.21

Georgiana Bianca Constantin „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
D. Firescu Dunarea de Jos University, Faculty of Medicine and Pharmacy, Galati, Romania & Clinical Emergency County Hospital Sf. Ap. Andrei, Galati, Romania
D. Voicu Dunărea de Jos University, Faculty of Medicine and Pharmacy, Galati, Romania
B. Ștefănescu „Dunărea de Jos” University, Faculty of Medicine and Pharmacy, Galati, Romania & Clinical Emergency County Hospital Sf. Ap. Andrei, Galati, Romania
R. Mihailov „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Cristina Șerban „Dunărea de Jos” University, Faculty of Medicine and Pharmacy, Galati, Romania & Clinical Emergency County Hospital Sf. Ap. Andrei, Galati, Romania
Rodica Bîrlă „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania & „Sf. Maria” Clinical Hospital, Bucharest, Romania
S. Constantinoiu „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania & „Sf. Maria” Clinical Hospital, Bucharest, Romania

DOI: https://doi.org/10.33695/rojes.v2i1.21

Keywords: colorectal cancer, emergency surgery, Hartmann, reversal

Abstract

The Hartmann procedure still has an important place in the surgical therapy of complicated colorectal cancers. The morbidity rate can be very high and many patients never undergo the stoma reversal. We conducted a retrospective study on 431 patients with colorectal cancer operated in the second clinic of General Surgery of the Clinical Emergency County Hospital Galati between 2008-2017. 42,53 % of the patients with Hartmann operation had a stoma reversal after a medium period of 5,7 months. The 5-years survival rate in patients with stoma reversal was 4,9 %. The reversal rate in our study is similar to those found in the literature in recent studies, that report percentages of 23,3 %-55,17 %. In our study, the medium period between the emergency Hartmann procedure and the reversal of the stoma was 5,7 months, which is also similar to the data in the literature. We found a 5-years survival rate of 4,9 % in patients with Hartmann reversal, much lower than others’ results. Many stomas initially intended to be temporary, may not be reversed. It is important to optimize the timing of stoma closure. A period of approximately 6 months between the initial operation and the reversal seem to be adequate.

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