Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 Jun 2;18(6):e0286562.
doi: 10.1371/journal.pone.0286562. eCollection 2023.

Postoperative effects of laparoscopic Hartmann reversal: A multicenter propensity score matched study

Kil-Yong Lee  1 , Jaeim Lee  1 , Seong Taek Oh  1 , Chul Seung Lee  2 , Nam Suk Kim  3 , Ju Myung Song  4 , Ri-Na Yoo  5 , Byung Jo Choi  6
Affiliations
Multicenter Study

Postoperative effects of laparoscopic Hartmann reversal: A multicenter propensity score matched study

Kil-Yong Lee et al. PLoS One. .

Abstract

Background: Although the advantages of laparoscopic Hartmann reversal (LHR) compared to open Hartmann reversal (OHR) have been reported in the literature, the number of multicenter studies with good matching investigating this topic is rare. In the present study, we aimed to confirm the advantages of LHR in terms of short-term outcomes through propensity score matching of LHR and OHR groups, using data collected from multiple institutions.

Methods: Patients who underwent Hartmann reversal at six institutions under the Catholic Medical Center of the Catholic University of Korea between January 1, 2005, and December 31, 2021, were included. The patients were divided into the LHR and OHR groups based on the technique used. The two groups were matched using propensity score matching (1:1 ratio, logistic regression with the nearest-neighbor method). The primary outcome was postoperative ileus (POI) frequency, and secondary outcomes were time to solid diet (days) and length of stay (days).

Results: Among 337 patients, propensity score matching was performed on 322, after excluding 15 who had undergone open conversion. Of these, 63 patients were assigned to each group through propensity score matching. There was no difference in the frequency of adhesiolysis (77.8% vs. 82.5%, p = 0.503) or the operation time. (210 (IQR 159-290) vs. 233 (IQR 160-280), p = 0.718) between the two groups. As the primary outcome, the LHR group showed significantly lower POI frequency than the OHR group. (4.8% vs. 22.2%, p = 0.0041) Regarding the secondary outcomes, the LHR group showed a shorter period to solid diet than the OHR group. The length of hospital stay was also significantly shorter in the LHR group (4 vs. 6, p < 0.0001; 9 vs. 12, p<0.0001).

Conclusion: LHR is an effective method to ensure faster recovery of patients after surgery compared to OHR.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of patient selection.
See this image and copyright information in PMC

References

    1. Bonjer HJ, Haglind E, Jeekel I, Kazemier G, Pahlman L, Hop WCJ et al.. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncology. 2005;6(7):477–84. doi: 10.1016/S1470-2045(05)70221-7 - DOI - PubMed
    1. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM et al.. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26. doi: 10.1016/S0140-6736(05)66545-2 - DOI - PubMed
    1. Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS et al.. Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet. 2004;363(9416):1187–92. doi: 10.1016/S0140-6736(04)15947-3 - DOI - PubMed
    1. Sallinen V, Di Saverio S, Haukijarvi E, Juusela R, Wikstrom H, Koivukangas V et al.. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO): an international, multicentre, randomised, open-label trial. Lancet Gastroenterol Hepatol. 2019;4(4):278–86. doi: 10.1016/S2468-1253(19)30016-0 - DOI - PubMed
    1. Gachabayov M, Oberkofler CE, Tuech JJ, Hahnloser D, Bergamaschi R. Resection with primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a systematic review and meta-analysis. Colorectal Dis. 2018;20(9):753–70. doi: 10.1111/codi.14237 - DOI - PubMed

Publication types