Quality of Life after Emergency Hartmann’s Procedure: A Single Centre Retrospective Study

Abstract

Background: Hartmann?s Procedure (HP) is the resection of the recto-sigmoid colon and creation of an end colostomy. Quality of Life (QoL) is increasingly considered before surgical intervention. This study assesses the patient?s perspective (QoL) before the HP, while the stoma is present and after reversal. Methods: Considered were patients who underwent emergency HP at our institution, between March 2014 and September 2017. The World Health Organization quality of life abbreviated questionnaire (WHOQOL-BREF) was used. An invitation letter and a copy of the questionnaire were sent to the patients, followed by a phone interview. Each patient completed the same questionnaire in relation to three time periods: Before Hartmann?s HP (BH), after Hartmann?s HP with Stoma Present (SP) and after Stoma Reversal (SR). Twice or 3 times, if the stoma was not reversed or was reversed. Results: Eighty-seven patients underwent emergency HP; 38 (43.7%) participated in the study. Fourteen (36.8%) patients had their stomas reversed. No difference in Qol, satisfaction with health, physical health, social relationships and environment between the periods BH vs. SP and BH vs. SR. There was an improvement from SP to SR. Psychological health scores were worse from BH to SP, but better from the SP to SR periods. Complications were the only predictor of outcome, except in psychological health and only after reversal of stoma. Conclusion: Emergency HP does not lower the general QoL but has a negative impact on psychological health. Stoma reversal engenders positive changes in QoL perception, while morbidity after stoma reversal predicts poorer outcomes.The article is available via Open Access. Click on the 'Additional link' above to access the full-text.Unknow