“Reversal of the end colostomy following a Hartmann’s procedure (HP) remains a frequently performed operation, undertaken by colorectal and general surgeons. While Henri Hartmann initially described the procedure in 1921 as a treatment for rectosigmoid cancer, it is now most commonly employed in cases of Hinchey 3 and 4 diverticulitis, where performance of a primary anastomosis is considered unsafe. Trauma, colorectal malignancy, inflammatory bowel disease and ischaemic colitis are other common reasons for performing HP in the USA. Ideally, Hartmann’s reversal (HR) is performed once the patient has recovered from the initial illness in order to re-establish intestinal continuity and avoid a permanent stoma. Historically this procedure has had low rates of success and a high morbidity, leading
to the presence of a permanent stoma in a substantial percentage of patients.

“This paper analyses a large institutional series of reversal of Hartmann’s procedure and provides a new perspective on the outcomes in specialized referral centres. Restoration
of bowel continuity following Hartmann’s procedure is a major surgical undertaking and in previously published literature has been associated with a low probability of success. Although it is associated with significant morbidity we describe a high success rate for restoration of intestinal continuity, at times in patients who have been denied surgery at other locations.”