Routine evaluation of the distal colon remnant before Hartmann's reversal is not necessary in asymptomatic patients.

<bold>Background: </bold>Reversal of Hartmann's is a common surgical procedure. Routine preoperative evaluation of the distal colonic/rectal remnant (DCRR) with contrast and/or endoscopic studies is frequently performed despite lack of evidence to support this practice. We hypothesize that asymptomatic patients can safely undergo Hartmann's reversal without preoperative DCRR evaluation.<bold>Methods: </bold>Adult patients undergoing reversal of Hartmann's at a single institution were retrospectively identified. Operative characteristics and outcomes in patients with and without preoperative DCRR evaluation were compared.<bold>Results: </bold>Between 1993 and 2008, 203 patients underwent reversal of Hartmann's at a tertiary referral center. Sixty-eight patients (33%) did not undergo preoperative DCRR evaluation and had comparable demographic characteristics, comorbidities, DCRR length, and perioperative outcomes to 135 patients who underwent preoperative contrast and/or endoscopic studies. After evaluation, 125 (93%) patients had normal findings, seven (5%) patients had abnormal studies that did not impact their management, and three (2%) patients underwent additional procedures.<bold>Conclusion: </bold>Hartmann's reversal without previous DCRR evaluation is acceptable in selected asymptomatic patients, without increased risk of complications. [ABSTRACT FROM AUTHOR]