Surgical Outcomes of Open and Laparoscopic Hartmann Reversal: A Single-Center Comparative Study

TL;DR

This study compares laparoscopic and open methods for Hartmann reversal, finding that the laparoscopic approach leads to shorter hospital stays and quicker recovery.

Contribution

The study provides a single-center comparison of surgical outcomes between laparoscopic and open Hartmann reversal techniques.

Findings

Laparoscopic Hartmann reversal was associated with shorter hospital stays compared to the open method.

Patients undergoing laparoscopic reversal returned to a solid diet faster than those with open surgery.

No significant differences were found in postoperative complications between the two groups.

Abstract

Background and objectives: Hartmann reversal (HR) is challenging and traditionally requires a large laparotomy wound. With the development of minimally invasive techniques, laparoscopic reversal of Hartmann's operation (HO) was attempted. We aimed to evaluate the outcomes of laparoscopic Hartmann reversal (LHR) versus open Hartmann reversal (OHR).

Materials and methods: In this study, we included 33 patients who underwent HR at Chi Mei Medical Center between January 2015 and March 2023. Ten patients received LHR, while 23 received OHR. We compared patient demographics, perioperative outcomes, early postoperative complications, and late postoperative complications between the two groups.

Results: There was no significant difference in the baseline demographics of both groups. Compared to the open method, the LHR group had a shorter hospital stay and time to solid diet. The median length of hospital stay in the OHR and LHR groups was 15.00 (Q1-Q3: 13.00-16.00) and 11.5 (Q1-Q3: 10.00-14.00) days (p = 0.028), respectively. The median time to solid diet was 8.00 (Q1-Q3: 7.00-8.00) days in the OHR group and 5.00 (Q1-Q3: 5.00-7.00) days in the LHR group (p = 0.022). No statistical significance between the groups was noticed in early and late postoperative complications.

Conclusions: Whether using a laparoscopic or an open method, HR is challenging. In our study, patients who underwent LHR were associated with reduced hospital stays and faster bowel movements.

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