Introduction Hartmann’s operations are still commonly performed, and its reversal is often challenging with recognised considerable morbidity and mortality. We examined outcomes of single-port access (SPA) laparoscopic reversal surgery in comparison to outcomes of conventional multiport (CL) and open operations.
Method Retrospective single-centre analysis of all patients who underwent Hartmann’s reversal between 2007–2014.
Results Seventy-eight patients underwent Hartmann’s reversal; the intended approach was open in 28 (35.9%), CL in 12 (15.4%) and SPA in 38 (48.7%) cases. There was no difference between the groups for patient’s age, gender, ASA grade and BMI. Conversion rates were 4/12 (33.3%) for CL and 3/38 (7.9%) for SPA. Including conversions, operating time was significantly shorter for the SPA group compared to the CL and open groups (154, 220 and 217 min, respectively). There was no difference in the time to first bowel movement between the groups, but post-op morbidity was significantly lower for SPA (23.7% vs 66.7% for CL and 39.3% for open surgery). Length of hospital stay was also lowest for SPA compared to CL and open (median 4, 6 and 7 days, respectively).
Conclusion SPA Reversal of Hartmann’s operation appears to have better results for some outcomes compared to both laparoscopic and open techniques. It is a safe and potentially superior technique that should be considered as first-line approach to restore bowel continuity in these often challenging patients.
Disclosure of interest None Declared.
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