Laparoscopic versus open Hartmann reversal: a propensity score matching analysis

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Hartmann surgery is a common procedure for colorectal cancer (CRC).
• Hartmann reversal (HR) aims to restore bowel continuity.
• Comparing laparoscopic (LHR) and open (OHR) approaches is crucial for patient outcomes.

Purpose of the Study:

• To compare short-term outcomes of laparoscopic Hartmann reversal (LHR) versus open Hartmann reversal (OHR).
• To evaluate the safety and efficacy of LHR compared to OHR in patients with a history of Hartmann surgery for CRC.

Main Methods:

• Retrospective enrollment of 89 patients who underwent Hartmann reversal (HR) between June 2013 and June 2022.
• Propensity score matching (PSM) analysis to compare LHR and OHR groups.
• Multivariable logistic regression to identify risk factors for HR-related complications.

Main Results:

• No significant differences were observed in operation time, blood loss, hospital stay, or postoperative complications between LHR and OHR groups after PSM.
• Pre-operative albumin levels < 42.0 g/L were identified as an independent risk factor for HR-related complications.
• Neither LHR nor OHR was found to be a predictive risk factor for complications.

Conclusions:

• Laparoscopic Hartmann reversal (LHR) and open Hartmann reversal (OHR) demonstrate comparable short-term prognoses.
• LHR presents advantages due to its less invasive nature, potentially improving patient recovery.
• Further research may elucidate long-term benefits of minimally invasive approaches in HR.