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A comparative study between open versus laparoscopic Hartmann reversal: A single-center experience and analysis
Hye Jung Cho1, Woo Ram Kim, Jong Woo Kim
1Division of Coloproctology, Department of General Surgery, Bundang CHA Medical Center, CHA University College of Medicine, Seongnam, Republic of Korea.
Medicine
|December 29, 2021
Summary
Hartmann reversal (HR) is a complex colorectal surgery. Laparoscopic Hartmann reversal (LHR) offers a safe and effective alternative to open procedures, with reduced operation time and blood loss in selected patients.
Area of Science:
- Colorectal Surgery
- Surgical Techniques
- Minimally Invasive Surgery
Background:
- Hartmann reversal (HR) is a challenging colorectal procedure associated with significant morbidity and mortality.
- Evaluating surgical approaches for HR is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the outcomes of open Hartmann Reversal (OHR) versus Laparoscopic Hartmann Reversal (LHR).
- To assess the safety and efficacy of HR in a selected patient cohort.
Main Methods:
- A retrospective review of 30 patients who underwent HR between December 2012 and January 2020.
- Patients were divided into two groups: LHR (n=20) and OHR (n=10).
- Data collected included operative time, blood loss, complications, and time to flatus.
Main Results:
- No conversions from LHR to OHR were required, and no ileostomy formations occurred post-reversal.
- Mean operative time and blood loss were lower in the LHR group compared to OHR.
- No anastomotic leakage was reported, with a low rate of severe complications (1 case of grade 3A).
Conclusions:
- Hartmann reversal can be performed safely in well-selected patients.
- Laparoscopic Hartmann Reversal presents an attractive option, potentially leading to shorter operation times, reduced blood loss, decreased pain, and shorter hospital stays.
