This topic is about the possibility of reversing a colostomy after a Hartmann’s procedure, especially when only a small portion of the rectal stump remains. Sally, who had this procedure due to aggressive rectal cancer, is exploring her chances of reversal. Here are some insights and advice based on similar experiences:

1. A short rectal stump and the time since surgery can lower the chances of a successful reversal.
- Many people find that surgeons consider Hartmann’s stomas permanent if the rectal stump is very short or if the reversal is delayed beyond the first year.
- Losing more of the colon can make reconnecting the bowel more difficult.

2. Surgeons usually prefer to operate, so hesitation might indicate a low chance of success.
- If a colorectal surgeon, who typically likes to perform surgeries, is hesitant, it might be wise to consider their caution seriously.

3. There are potential risks if a reversal is attempted.
- If the reversal fails, it could lead to emergency surgery and result in an ileostomy, which some find more challenging to manage.
- Each surgery increases the risk of adhesions and weakens the abdominal wall, raising the chance of a parastomal hernia.

4. Even if the connection is successful, there might be functional issues.
- With much of the rectum removed, the ability to store stool is greatly reduced, leading to frequent and often watery bowel movements, along with electrolyte loss.
- One person reported needing to use the toilet over 30 times a day after reconstruction and eventually chose to return to a stoma.

5. It’s important to get a specialist’s assessment.
- Seeking a second opinion from an experienced colorectal surgeon can provide a clearer understanding of the anatomical possibilities and risks involved.

6. Psychological adjustment might be easier than undergoing high-risk surgeries repeatedly.
- Long-term ostomates suggest focusing on managing and accepting the stoma, seeing it as a sign of survival rather than a loss.
- Support from the community can help with body image and daily life challenges related to living with a stoma.

7. Outcomes can vary widely.
- One person successfully had a Hartmann’s reversal within a few months and is now two months post-operation, though they are still dealing with some post-surgical bleeding that needs attention.

8. An inspirational thought to consider: “Things turn out best for the people who make the best of the way things turn out.” — John Wooden