Single-port laparoscopic versus open Hartmann’s reversal: a retrospective analysis on surgical and postoperative outcomes

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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.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.