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Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study.

Paolo Panaccio1,2,3, Tommaso Grottola1,2, Rossana Percario3

  • 1Department of Medicine and Oral Sciences and Biotechnologies, Unit of General and Oncology Surgery, Casa Di Cura Pierangeli, University G. D'Annunzio, Chieti-Pescara, Italy.

Surgery Research and Practice
|February 8, 2021
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Summary
This summary is machine-generated.

Laparoscopic reversal of Hartmann's procedure (LHR) is a safe and effective alternative to open reversal (OHR), offering reduced complications and shorter hospital stays. This study found LHR resulted in less blood loss and faster recovery compared to OHR.

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Area of Science:

  • Colorectal surgery
  • Minimally invasive surgery
  • Surgical outcomes

Background:

  • Hartmann's procedure reversal is a common surgical intervention.
  • Laparoscopic reversal of Hartmann's procedure (LHR) is increasingly adopted.
  • Comparison between LHR and open Hartmann's reversal (OHR) is crucial for clinical decision-making.

Purpose of the Study:

  • To compare the outcomes of laparoscopic reversal of Hartmann's procedure (LHR) versus open Hartmann's reversal (OHR).
  • To evaluate the safety and efficacy of LHR in patients who previously underwent open surgery.

Main Methods:

  • Retrospective evaluation of 34 patients undergoing Hartmann reversal between January 2017 and July 2019.
  • Patients were divided into two groups: LHR (n=17) and OHR (n=17).
  • Key variables analyzed included operation time, blood loss, hospital stay, morbidity, and mortality.

Main Results:

  • Both groups were homogeneous in terms of demographics and comorbidities.
  • LHR group showed significantly less intraoperative blood loss (100 mL vs. 450 mL), shorter time to flatus (2.4 days vs. 3.6 days), and reduced hospitalization (4.4 days vs. 11.2 days).
  • Morbidity rates were similar, but OHR had more severe complications; mortality was zero in both groups.

Conclusions:

  • Laparoscopic reversal of Hartmann's procedure is feasible and safe, even after primary open surgery.
  • Careful patient selection and experienced laparoscopic surgeons are recommended for optimal LHR outcomes.
  • LHR offers significant advantages in terms of recovery and complication rates compared to OHR.