Hartmann Reversal

Lin, Fu-Lin; Boutros, Marylise; Silva, Giovanna M. da; Weiss, Eric G.; Lu, Xingrong; Wexner, Steven D.

doi:10.1097/dcr.0b013e318270a1a3

Cited by 27 publications

(10 citation statements)

References 22 publications

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“…Park et al argued that age was the most important influencing factor in their study [11] , while high ASA score may reduce the reversal rate [12] . Nonetheless, other study contradicts such claim by arguing that high ASA did not contribute to higher postoperative complication rate [13] . In our study, only 13% of patients had ASA of I while 87% were II or more.…”

Section: Discussioncontrasting

confidence: 57%

A comparative study between open versus laparoscopic Hartmann reversal

Cho

Kim

2021

Medicine

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As one of the most challenging procedures in colorectal surgery, Hartmann reversal (HR) carries a burden of morbidity and mortality. We report our experience and compare open and laparoscopic HR.Between December 2012 and January 2020, 30 patients who underwent Hartmann reversal were reviewed. All patients either received laparoscopic or open reversal.Of the 87 patients who underwent Hartmann operation (HO), 30 patients received HR (Laparoscopic Hartmann Reversal, [LHR], n = 20; Open Hartmann Reversal, Open Hartmann Reversal [OHR], n = 10). There were 15 males and 15 female patients. The mean operation time was 223.8 minutes (range 115-350 minutes) with mean blood loss of 252.5 mL (range 0-700 mL). There was no conversion from LHR to OHR, and there was no ileostomy formation. Mean time to flatus was 5.0 days (range 2-13 days). There were 15 early postoperative complications and 5 late postoperative complications, but only 1 case of grade 3A. No anastomosis leakage was reported.HR is an operation that can be performed safely in well-selected patients. Minimally invasive techniques, such as LHR, is an attractive option resulting in shorter operation time, less blood loss, less pain, and shorter hospital stay.

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Section: Discussioncontrasting

confidence: 57%

A comparative study between open versus laparoscopic Hartmann reversal

Cho

Kim

2021

Medicine

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“…With reference to the primary surgery, i.e., Hartmann procedure (HP), most of the included studies did not provide detailed data about surgical approach. [2, 11, 17–19, 23, 26–31, 34, 36–40]. In seven studies, all HPs were performed by open surgery, [21, 22, 24, 32, 33, 35] while two articles did include both patients who had received open surgery and patients who had received surgery by laparoscopy.…”

Section: Resultsmentioning

confidence: 99%

“…Full texts with relative bibliographies were thus appraised, and a total of 26 studies were eventually deemed suitable for inclusion and data extraction. [2, 11, 17–40] The selection process is given in Fig. 1, while Table 1 describes the general characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

Conventional Versus Minimally Invasive Hartmann Takedown: A Meta‐analysis of the Literature

et al. 2019

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Although end colostomy closure following Hartmann's procedure is a major surgery that is traditionally performed by conventional celiotomy, over the last decade there has been a growing interest toward the application of different minimally invasive techniques. We aimed at evaluating the relative outcomes of conventional surgery versus minimally invasive surgery by meta-analyzing the available data from the medical literature. The PubMed/ MEDLINE, Cochrane Library and EMBASE electronic databases were searched through August 2018. Inclusion criteria considered eligible all comparative studies evaluating open versus minimally invasive procedures. Conventional laparoscopy, robotic and single-port laparoscopy were considered as minimally invasive techniques. Overall morbidity, rate of anastomotic failure, rate of wound complications and mortality were evaluated as primary outcomes. Perioperative details and surgical outcomes were also assessed. The data of a total of 13,740 patients from 26 studies were eventually included in the analysis. There were no significant differences on baseline characteristics such as age, BMI and proportion of high-risk patients between the two groups of patients. As compared to the conventional technique, minimally invasive surgery proved significantly superior in terms of postoperative morbidity, length of hospital stay and rate of incisional hernia. The current literature suggests that minimally invasive surgery should be considered in performing Hartmann's reversal, if technically viable. However, due to the low level of the available evidence it is impossible to draw definitive conclusions.

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“…The length of intensive care unit (ICU) stay was also significantly ( p = 0.003) shorter in the LG [LG 0 days (0–2); OG 1 day (0–12)]. Significant advantages associated with a laparoscopic procedure were observed for the return to normal bowel function (measured as a clinical parameter by bowel sounds; LG 3 days [2–4]; OG 4 days [2–9]; p < 0.0001), the return to normal diet (LG: 3 days [2–6]; OG 4 days [2–10]; p = 0.001), and in the postoperative continuous use of analgesics (non‐steroidal anti‐inflammatory drug [NSAID] or morphine preparations) in days (LG 7 days [6–10]; OG 12 days [6–30]; p < 0.0001). The length of the overall hospital stay (LOS) was also significantly shorter in the LG, with a median of 9 days (7–14) compared with 15 days (8–163) in the OG ( p < 0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…In current literature, different results have been reported. Whereas Lin et al [15] found no associations between time to reversal and complications, Pearce et al [16] reported that risks of postoperative complications in reversals were significantly greater in patients who underwent the procedure within 6 months after primary operation versus those whose reversal was delayed longer than 6 months. Conversely, further studies have reported that a longer time to reversal (>9 months) was associated with greater risks of postoperative complications [17–19].…”

Section: Discussionmentioning

confidence: 99%