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. 2021 Jan 23:2021:4547537.
doi: 10.1155/2021/4547537. eCollection 2021.

Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study

Paolo Panaccio  1   2   3 , Tommaso Grottola  1   2 , Rossana Percario  3 , Federico Selvaggi  2   3 , Severino Cericola  3 , Alfonso Lapergola  2 , Maira Farrukh  2 , Giuseppe Di Martino  2 , Marco Ricciardiello  1   2 , Pierluigi Di Sebastiano  1   2 , Fabio Francesco Di Mola  1   2
Affiliations

Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study

Paolo Panaccio et al. Surg Res Pract. .

Abstract

Background: Laparoscopic reversal of Hartmann's procedure (LHR) offers reduced morbidity compared with open Hartmann's reversal (OHR). The aim of this study is to compare the outcome of laparoscopic versus open Hartmann reversal.

Materials and methods: Thirty-four patients who underwent Hartmann reversal between January 2017 and July 2019 were evaluated. Patients underwent either LHR (n = 17) or OHR (n = 17). Variables such as numbers of patients, patient's age, sex, body mass index (BMI), comorbidities, ASA (American Society of Anesthesiology) score, indication for previous open sigmoid resection, mean operation time, rate of conversion to open surgery, length of hospital stay, mortality, and morbidity were retrospectively evaluated.

Results: The two groups of patients were homogeneous for gender, age, body mass index, cause of primary surgery, time to reversal, and comorbidities. In 97% of the cases, HP was done by open surgery. Our data revealed no difference in mean operation time (LHR: 180.5 ± 35.1 vs. OHR: 225.2 ± 48.4) and morbidity rate, although, in OHR group, there were more severe complications. Less intraoperative blood loss (LHR: 100 ± 40 mL vs. OHR: 450 ± 125 mL; p value <0.001), shorter time to flatus (LHR: 2.4 days vs. OHR: 3.6 days; p value <0.021), and shorter hospitalization (LHR: 4.4 vs. OHR: 11.2 days; p value <0.001) were observed in the LHR group. Mortality rate was null in both groups. Discussion. LHR is feasible and safe even for patients who received a primary open Hartmann's procedure. We suggest careful patient's selection allowing LHR procedures to highly skilled laparoscopy surgeons.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Trocar's positions with Alexis® wound protector.
Figure 2
Figure 2
ICG-indocyanine green intraoperative angiography showing bowel perfusion.
See this image and copyright information in PMC

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