Hartmann's reversal: a comparative study between laparoscopic and open approaches

Background A reversal of Hartmann's procedure can be performed using either a laparoscopic or open approach. However, laparoscopic reversal (LR) of Hartmann's procedure is challenging. This study was designed to compare the results between open and laparoscopic approaches. Methods This was...

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Bibliographic Details
Published in:ANZ journal of surgery 2018-05, Vol.88 (5), p.450-454
Main Authors: Kwak, Han Deok, Kim, Jin, Kang, Dong Woo, Baek, Se‐Jin, Kwak, Jung Myun, Kim, Seon‐Hahn
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Chi-Square Distribution
Cohort Studies
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Colorectal Surgery - adverse effects
Colorectal Surgery - methods
Databases, Factual
Disease-Free Survival
Female
Hartmann's procedure
Humans
laparoscopic
Laparoscopy - adverse effects
Laparoscopy - methods
Laparotomy - adverse effects
Laparotomy - methods
Male
open
Operative Time
outcome
Postoperative Complications - epidemiology
Postoperative Complications - physiopathology
Reoperation - statistics & numerical data
Republic of Korea
Retrospective Studies
reversal
Risk Assessment
Statistics, Nonparametric
Survival Analysis
Treatment Outcome
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Summary:Background A reversal of Hartmann's procedure can be performed using either a laparoscopic or open approach. However, laparoscopic reversal (LR) of Hartmann's procedure is challenging. This study was designed to compare the results between open and laparoscopic approaches. Methods This was a retrospective study of prospectively collected data. We analysed 29 patients who received Hartmann's reversal at Korea University Anam Hospital between April 2007 and September 2014. All patients underwent either LR (n = 17) or open reversal (OR, n = 12). Results Patient characteristics were similar between the LR and OR groups. There was also no difference in mean operation time (212.5 versus 251.8 min), diversion ileostomy, length of hospital stay, postoperative analgesic days, time to diet resumption (3.9 versus 6.2 days) or complication rate. Although the time to resuming a solid diet was not different between the two groups (P = 0.053), bowel movement occurred faster in LR patients (LR versus OR, 1.8 versus 2.8 days, P = 0.020). Patients in the LR group also had less blood loss during surgery (114.1 versus 594.2 mL, P = 0.026). There were no mortalities in this study. Conclusion LR of Hartmann's procedure resulted in faster bowel function recovery than the open method. Laparoscopic approaches are feasible even for patients who received an open Hartmann's procedure.
ISSN:1445-1433
1445-2197
DOI:10.1111/ans.13979