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Laparoscopically assisted Hartman's reversal is an efficacious and efficient procedure: a case control study
E Chouillard1, T Pierard, R Campbell
1Department of General and Digestive Surgery Centre Hospitalier, Poissy, France. chouillard@yahoo.com
Minerva Chirurgica
|April 28, 2009
Summary
Laparoscopic Hartmann's reversal is a safe and effective procedure, showing lower morbidity and shorter hospital stays compared to open surgery. This minimally invasive approach offers potential cost savings through reduced hospital stays.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Hartmann's procedure reversal is often challenging due to adhesions.
- Laparoscopic approaches may offer advantages over open surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic Hartmann's reversal.
- To compare laparoscopic reversal with open Hartmann's reversal.
Main Methods:
- Retrospective review of 44 patients undergoing laparoscopic Hartmann's reversal (Group A).
- Case-control comparison with 44 patients undergoing open Hartmann's reversal (Group B).
Main Results:
- Laparoscopic reversal had a significantly lower morbidity rate (11.4% vs 28.6%) and shorter hospital stay (4.8 vs 6.8 days).
- Mortality rates were 2.2% for laparoscopic and 0% for open procedures.
- Conversion rate for laparoscopy was 9.1%; operative incidents and duration were comparable.
- Laparoscopic reversal did not generate significant additional costs.
Conclusions:
- Laparoscopic Hartmann's procedure reversal is a safe and efficient alternative to open surgery.
- The laparoscopic approach leads to reduced morbidity and length of hospital stay.
- Indirect cost reduction is achieved through shorter hospitalizations.
