Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients
Abstract Background Hartmann's procedure (HP) is used in surgical emergencies such as colonic perforation and colonic obstruction. “Temporary” colostomy performed during HP is not always reversed in part due to potential morbidity and mortality associated with reversal. There are several contri...
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| Format: | Article |
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Wiley
2022-09-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.788 |
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| author | Anwar Medellin Abueta Nairo Javier Senejoa Mauricio Pedraza Ciro Lina Fory Carlos Perez Rivera Carlos Edmundo Martinez Jaramillo Lina Maria Mateus Barbosa Heinz Orlando Ibañez Varela Javier A. Carrera Rafael Garcia Duperly Luis A Sanchez Ivan David Lozada‐Martinez Luis Felipe Cabrera‐Vargas Andres Mendoza Paulo Cabrera Sebastian Sanchez Ussa Cristian Paez Steven D. Wexner Victor Strassmann Giovanna DaSilva Salomone Di Saverio Arianna Birindelli Roberto Jose Rodríguez Florez Abraham Kestenberg Alexander Obando Rodallega Juan Carlos Sánchez Robles Carlos Adrian Niño Carrasco Alessio Impagnatiello Diletta Cassini Gianandrea Baldazzi Francesco Roscio Gianluca Liotta Pierluigi Marini Daniel Gomez Carlos Edgar Figueroa Avendaño Daniela Moreno Villamizar Laura Cabrera Juan Carlos Reyes Alexis Narvaez‐Rojas |
| author_facet | Anwar Medellin Abueta Nairo Javier Senejoa Mauricio Pedraza Ciro Lina Fory Carlos Perez Rivera Carlos Edmundo Martinez Jaramillo Lina Maria Mateus Barbosa Heinz Orlando Ibañez Varela Javier A. Carrera Rafael Garcia Duperly Luis A Sanchez Ivan David Lozada‐Martinez Luis Felipe Cabrera‐Vargas Andres Mendoza Paulo Cabrera Sebastian Sanchez Ussa Cristian Paez Steven D. Wexner Victor Strassmann Giovanna DaSilva Salomone Di Saverio Arianna Birindelli Roberto Jose Rodríguez Florez Abraham Kestenberg Alexander Obando Rodallega Juan Carlos Sánchez Robles Carlos Adrian Niño Carrasco Alessio Impagnatiello Diletta Cassini Gianandrea Baldazzi Francesco Roscio Gianluca Liotta Pierluigi Marini Daniel Gomez Carlos Edgar Figueroa Avendaño Daniela Moreno Villamizar Laura Cabrera Juan Carlos Reyes Alexis Narvaez‐Rojas |
| author_sort | Anwar Medellin Abueta |
| collection | DOAJ |
| description | Abstract Background Hartmann's procedure (HP) is used in surgical emergencies such as colonic perforation and colonic obstruction. “Temporary” colostomy performed during HP is not always reversed in part due to potential morbidity and mortality associated with reversal. There are several contributing factors for patients requiring a permanent colostomy following HP. Therefore, there is still some discussion about which technique to use. The aim of this study was to evaluate perioperative variables of patients undergoing Hartmann's reversal using a laparoscopic and open approach. Methods The multicenter retrospective cohort study was done between January 2009 and December 2019 at 14 institutions globally. Patients who underwent Hartmann's reversal laparoscopic (LS) and open (OS) approaches were evaluated and compared. Sociodemographic, preoperative, intraoperative variables, and surgical outcomes were analyzed. The main outcomes evaluated were 30‐day mortality, length of stay, complications, and postoperative outcomes. Results Five hundred and two patients (264 in the LS and 238 in the OS group) were included. The most prevalent sex was male in 53.7%, the most common indication was complicated diverticular disease in 69.9%, and 85% were American Society of Anesthesiologist (ASA) II‐III. Intraoperative complications were noted in 5.3% and 3.4% in the LS and OS groups, respectively. Small bowel injuries were the most common intraoperative injury in 8.3%, with a higher incidence in the OS group compared with the LS group (12.2% vs. 4.9%, p < 0.5). Inadvertent injuries were more common in the small bowel (3%) in the LS group. A total of 17.2% in the OS versus 13.3% in the LS group required intensive care unit (ICU) admission (p = 0.2). The most frequent postoperative complication was ileus (12.6% in OS vs. 9.8% in LS group, p = 0.4)). Reintervention was required mainly in the OS group (15.5% vs. 5.3% in LS group, p < 0.5); mortality rate was 1%. Conclusions Laparoscopic Hartmann's reversal is safe and feasible, associated with superior clinical outcomes compared with open surgery. |
| first_indexed | 2024-03-12T21:50:02Z |
| format | Article |
| id | doaj.art-408c7176b18d4b929bfa37aac9507dfa |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-03-12T21:50:02Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-408c7176b18d4b929bfa37aac9507dfa2023-07-26T04:11:54ZengWileyHealth Science Reports2398-88352022-09-0155n/an/a10.1002/hsr2.788Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patientsAnwar Medellin Abueta0Nairo Javier Senejoa1Mauricio Pedraza Ciro2Lina Fory3Carlos Perez Rivera4Carlos Edmundo Martinez Jaramillo5Lina Maria Mateus Barbosa6Heinz Orlando Ibañez Varela7Javier A. Carrera8Rafael Garcia Duperly9Luis A Sanchez10Ivan David Lozada‐Martinez11Luis Felipe Cabrera‐Vargas12Andres Mendoza13Paulo Cabrera14Sebastian Sanchez Ussa15Cristian Paez16Steven D. Wexner17Victor Strassmann18Giovanna DaSilva19Salomone Di Saverio20Arianna Birindelli21Roberto Jose Rodríguez Florez22Abraham Kestenberg23Alexander Obando Rodallega24Juan Carlos Sánchez Robles25Carlos Adrian Niño Carrasco26Alessio Impagnatiello27Diletta Cassini28Gianandrea Baldazzi29Francesco Roscio30Gianluca Liotta31Pierluigi Marini32Daniel Gomez33Carlos Edgar Figueroa Avendaño34Daniela Moreno Villamizar35Laura Cabrera36Juan Carlos Reyes37Alexis Narvaez‐Rojas38Department of Colorectal Surgery Fundación Santa Fe de Bogotá Bogotá ColombiaDepartment of Colorectal Surgery Hospital Militar Central Bogotá ColombiaDepartment of Surgery Universidad El Bosque Bogotá ColombiaDepartment of General Surgery Hospital Militar Central Bogotá ColombiaDepartment of General Surgery Fundación Cardioinfantil Bogotá ColombiaDepartment of Colorectal Surgery Hospital Militar Central Bogotá ColombiaDepartment of Colorectal Surgery Hospital Militar Central Bogotá ColombiaDepartment of Colorectal Surgery Hospital Militar Central Bogotá ColombiaDepartment of Colorectal Surgery Fundación Santa Fe de Bogotá Bogotá ColombiaDepartment of Colorectal Surgery Fundación Santa Fe de Bogotá Bogotá ColombiaDepartment of Colorectal Surgery Hospital Militar Central Bogotá ColombiaMedical and Surgical Research Center Future Surgeons Chapter, Colombian Surgery Association Bogotá ColombiaMedical and Surgical Research Center Future Surgeons Chapter, Colombian Surgery Association Bogotá ColombiaDepartment of Surgery Universidad El Bosque Bogotá ColombiaDepartment of General Surgery Hospital Militar Central Bogotá ColombiaDepartment of Surgery Pontificia Universidad Javeriana Bogotá ColombiaDepartment of Surgery Fundación Universitaria Sanitas Bogotá ColombiaDepartment of Colorectal Surgery Cleveland Clinic Florida Weston FL USADepartment of Colorectal Surgery Cleveland Clinic Florida Weston FL USADepartment of Colorectal Surgery Cleveland Clinic Florida Weston FL USAEmergency and General Surgery Department CA Pizzardi Maggiore Hospital Bologna ItalyDepartment of Surgery Esine General Hospital ASST Valcamonica ItalyDepartment of Colorectal Surgery Hospital Central Militar Ciudad de México MéxicoDepartment of Colorectal Surgery Fundación Clínica Valle del Lili Cali ColombiaDepartment of Colorectal Surgery Fundación Clínica Valle del Lili Cali ColombiaDepartment of Colorectal Surgery Hospital Central Militar Ciudad de México MéxicoDepartment of Colorectal Surgery Hospital Central Militar Ciudad de México MéxicoDepartment of Surgery San Caillo – Forlanini Hospital Rome ItalyComplex Unit of General and Emergency Surgery Città di Sesto San Giovanni Hospital Milan ItalyComplex Unit of General and Emergency Surgery Città di Sesto San Giovanni Hospital Milan ItalyDepartment of General Surgery ASST Valle Olona Busto Arsizio ItalyDepartment of Surgery San Caillo – Forlanini Hospital Rome ItalyDepartment of Surgery San Caillo – Forlanini Hospital Rome ItalyDepartment of Surgery Universidad El Bosque Bogotá ColombiaDepartment of General Surgery Hospital Universitario Mayor Méderi Bogotá ColombiaDepartment of Surgery Universidad El Bosque Bogotá ColombiaDepartment of Surgery Universidad El Bosque Bogotá ColombiaDepartment of Colorectal Surgery Hospital Militar Central Bogotá ColombiaInternational Coalition on Surgical Research Universidad Nacional Autónoma de Nicaragua Managua NicaraguaAbstract Background Hartmann's procedure (HP) is used in surgical emergencies such as colonic perforation and colonic obstruction. “Temporary” colostomy performed during HP is not always reversed in part due to potential morbidity and mortality associated with reversal. There are several contributing factors for patients requiring a permanent colostomy following HP. Therefore, there is still some discussion about which technique to use. The aim of this study was to evaluate perioperative variables of patients undergoing Hartmann's reversal using a laparoscopic and open approach. Methods The multicenter retrospective cohort study was done between January 2009 and December 2019 at 14 institutions globally. Patients who underwent Hartmann's reversal laparoscopic (LS) and open (OS) approaches were evaluated and compared. Sociodemographic, preoperative, intraoperative variables, and surgical outcomes were analyzed. The main outcomes evaluated were 30‐day mortality, length of stay, complications, and postoperative outcomes. Results Five hundred and two patients (264 in the LS and 238 in the OS group) were included. The most prevalent sex was male in 53.7%, the most common indication was complicated diverticular disease in 69.9%, and 85% were American Society of Anesthesiologist (ASA) II‐III. Intraoperative complications were noted in 5.3% and 3.4% in the LS and OS groups, respectively. Small bowel injuries were the most common intraoperative injury in 8.3%, with a higher incidence in the OS group compared with the LS group (12.2% vs. 4.9%, p < 0.5). Inadvertent injuries were more common in the small bowel (3%) in the LS group. A total of 17.2% in the OS versus 13.3% in the LS group required intensive care unit (ICU) admission (p = 0.2). The most frequent postoperative complication was ileus (12.6% in OS vs. 9.8% in LS group, p = 0.4)). Reintervention was required mainly in the OS group (15.5% vs. 5.3% in LS group, p < 0.5); mortality rate was 1%. Conclusions Laparoscopic Hartmann's reversal is safe and feasible, associated with superior clinical outcomes compared with open surgery.https://doi.org/10.1002/hsr2.788colostomylaparoscopylaparotomyoperative surgical procedurespatient outcome assessment |
| spellingShingle | Anwar Medellin Abueta Nairo Javier Senejoa Mauricio Pedraza Ciro Lina Fory Carlos Perez Rivera Carlos Edmundo Martinez Jaramillo Lina Maria Mateus Barbosa Heinz Orlando Ibañez Varela Javier A. Carrera Rafael Garcia Duperly Luis A Sanchez Ivan David Lozada‐Martinez Luis Felipe Cabrera‐Vargas Andres Mendoza Paulo Cabrera Sebastian Sanchez Ussa Cristian Paez Steven D. Wexner Victor Strassmann Giovanna DaSilva Salomone Di Saverio Arianna Birindelli Roberto Jose Rodríguez Florez Abraham Kestenberg Alexander Obando Rodallega Juan Carlos Sánchez Robles Carlos Adrian Niño Carrasco Alessio Impagnatiello Diletta Cassini Gianandrea Baldazzi Francesco Roscio Gianluca Liotta Pierluigi Marini Daniel Gomez Carlos Edgar Figueroa Avendaño Daniela Moreno Villamizar Laura Cabrera Juan Carlos Reyes Alexis Narvaez‐Rojas Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients Health Science Reports colostomy laparoscopy laparotomy operative surgical procedures patient outcome assessment |
| title | Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients |
| title_full | Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients |
| title_fullStr | Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients |
| title_full_unstemmed | Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients |
| title_short | Laparoscopic Hartmann's reversal has better clinical outcomes compared to open surgery: An international multicenter cohort study involving 502 patients |
| title_sort | laparoscopic hartmann s reversal has better clinical outcomes compared to open surgery an international multicenter cohort study involving 502 patients |
| topic | colostomy laparoscopy laparotomy operative surgical procedures patient outcome assessment |
| url | https://doi.org/10.1002/hsr2.788 |
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