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Single-port laparoscopic versus open Hartmann's reversal: a retrospective analysis on surgical and postoperative
A Akmercan1, K D Batun2, H I Sevindi2
1General Surgery Department, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey. dr.akmercan@gmail.com.
Introduction:
This study aims to compare the intraoperative and postoperative outcomes of single-port laparoscopic Hartmann's reversal (SPLHR) and open Hartmann's reversal (OHR).
Material And Methods:
Consecutive patients who underwent OHR and SPLHR between 2019 and 2021 were analyzed retrospectively from a prospectively maintained database.
Results:
During the study period, 23 patients underwent SPLHR and 24 patients underwent OHR. The median age, gender, body mass index (BMI), comorbidities, and presence of midline/parastomal hernias were similar across the groups. The median estimated blood loss was significantly lower (100 versus 175 ml, p = 0.011), and also the median operation time (92 versus 120 min, p = 0.016) was shorter in the SPLHR group. Inadvertent bowel injury was more frequently observed in OHR group (37.5% versus 8.7%, p = 0.02). Overall postoperative complications did not differ between groups, but wound infections were significantly more common in the OHR group (33.3% versus 4.3%, p = 0.023). The SPLHR group experienced a shorter time to first flatus (median 2 versus 3 days, p = 0.04), a shorter time to resuming a soft diet (median 2 versus 3 days, p = 0.002), and a shorter length of hospital stay (4 versus 4.5 days, p = 0.007).
Conclusion:
This study confirms that SPLHR is a reliable and efficient method. SPLHR has several advantages in terms of perioperative morbidity and postoperative outcomes compared with OHR in selected patients.
