Colostomy Reversal After Hartmann's Procedure: Is It Possible?

Hi everybody, can anyone tell me if they've managed to have a reversal after a Hartmann's procedure and also a very short rectal stump? It's been over 2 years since my procedure, and my surgeon still can't answer my question if this is possible. He tells me that it's not that simple, as the cancer was quite aggressive and I only have 6 cm of the rectal stump left. It's just that I'm still finding it hard to accept my stoma, so if there was any chance, I would take it. Sally.

I think this reversal is sometimes possible but not always. I was told mine was permanent. I had aggressive rectal cancer, so not much stump is left.

I think from the way your surgeon is talking that he doesn't think a reversal will be successful for you. Surgeons generally want to operate, so when they start avoiding it, I take that as a sign.

Someone else may have more relevant experience to share.

What do you find difficult to accept about your stoma? Maybe we can help you with that.

The rectal stump may be only part of the problem; you may have lost quite a bit of colon also. Your surgeon is saying the surgery will be difficult — having the reversal work is likely even more improbable. Reversals are normally more successful the sooner the reversal is performed — you are wanting to have a complicated reversal after 2 years. If you are adamant, you should confer with a colorectal surgeon and have him explain to you the likelihood of success. I agree with @Susan, most surgeons have a God-like complex, and if they are advising against it, you should consider carefully. Another thing to consider is that a failure could lead to you having another surgery and an ileostomy, which is a little more difficult to manage. Each surgery adds adhesions and also weakens the abdominal wall — a weakened abdominal wall increases the likelihood of a parastomal hernia. In other words, a reversal failure could leave you with more complications. The Hartmann procedure has left you with a manageable life investment (stoma). Learn to manage it or consult with a colorectal surgeon.

Hi Sally,

I had my ileostomy reversed unsuccessfully. My surgeon used a piece of small bowel to make it function as a bit of large bowel, as I'd had almost all my large bowel removed. Eight months later, after running to the toilet up to and over 30 times a day, I was very glad to wake up from surgery, which lasted over 24 hours, to have my stoma back!!

But seriously, if your doctor says that it's not as simple as your cancer was aggressive, I wonder why you are pursuing this?

I've had my stoma for 28 years, and I wish I had not listened to my surgeon!!

I don't know how long you have had your stoma, but I found that after all this time, my stoma is a normal part of me. It's a sign that I survived all the trauma I went through. And although many people in my rural community know that I'm seriously ill, not many know that I have a stoma bag - after all, that is my business.

All the best,

Greetings from New Zealand,

Gracie

@Sally, I forgot to mention that your rectum is responsible for storing your effluent before releasing it to your anus for removal. Since half or more than half, depending on your anatomy, of your rectum has been removed, you won't have as much storage, leading to many more bathroom trips than you had previously. Also, your rectum absorbs any remaining liquids and electrolytes in order to firm up your effluent and prevent the loss of electrolytes. Considering you have also lost colon, your output would be watery. You can probably understand the consequences of frequent watery output. This is probably your best-case scenario. It seems your surgeon is trying to steer you away from making a bad choice.

“Things turn out best for the people who make the best of the way things turn out.”

—John Wooden

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

Hi, I wish to thank everybody for the replies. I think I will go back to the surgeon and have a further discussion with him. I've already had a hernia repair which didn't work; I think that has a lot to do with the way I view my stoma. Sally