Impact of socioeconomic deprivation and primary pathology on rate of reversal of Hartmann's procedure

BACKGROUND: Hartmann's procedure is an operation for left-sided colonic pathology where primary anastomosis is considered unsafe. The aim of this study was to assess the impact of socioeconomic deprivation and primary pathology on the rate of reanastomosis. METHODS: All patients who underwent Hartmann's procedure between 1992 and 2000 in our unit were included. The deprivation category (DEPCAT) scores from 1 (affluent) to 7 (most deprived) were calculated. RESULTS: An emergency procedure was performed in 118 of 124 patients. Primary pathology was malignant in 40 and benign in 84 patients. The DEPCAT scores were high (6,7) in 76 and intermediate (3 to 5) in 42 patients. Of the 102 patients surviving the postoperative period, only 23 underwent reversal. The reversal rate was lower in patients with malignancy (P = 0.005) and higher DEPCAT scores. CONCLUSIONS: Primary diagnosis and socioeconomic deprivation adversely influence the rate of reversal of Hartmann's procedure.