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Complication Rates After Hartmann's Reversal: Openvs.Laparoscopic Approach

Haughn, Christopher M.D.; Ju, Brian M.D.; Uchal, Miro M.D.; Arnaud, Jean Pierre M.D.; Reed, James F. Ph.D.; Bergamaschi, Roberto M.D. Ph.D.
Diseases of the Colon & Rectum: August 2008
doi: 10.1007/s10350-008-9264-x
Original Contribution: PDF Only

Purpose: Purpose:This study was performed to compare open Hartmann's reversal to laparoscopic Hartmann's reversal with regard to complication, readmission, and reoperation rates.

Methods: Methods:Data of patients who underwent open Hartmann's reversal or laparoscopic Hartmann's reversal between 1998 and 2004 at two institutions were collected. End points were complications in the hospital or after discharge, readmission to the hospital, and reoperation within 6 months after initial surgery.

Results: Results:Sixty-one open Hartmann's reversal and 61 laparoscopic Hartmann's reversal patients were well matched except for American Society of Anesthesiology grade (1.9vs.1.6;P= 0.008), timing of Hartmann's procedure (14vs. 6 months;P= 0.001), operation time (210vs.154 minutes;P= 0.001), and estimated blood loss (363vs.254ml;P= 0.01). Thirty-day complication rates did not differ (18vs.13 percent). At 6 month follow-up, open Hartmann's reversal patients had increased complication (16.4vs.3.3 percent;P= 0.015) and reoperation (13.1vs.3.3 percent;P= 0.048) rates but the same readmission rates (16.4 percent).

Conclusions: Conclusions:Compared with open Hartmann's reversal, 6 month complication and reoperation rates were lower in laparoscopic Hartmann's reversal patients. Most of the six-month complications and reoperations in open Hartmann's reversal were abdominal wall-related. Readmission rates were similar, but reasons for readmission were surgical in open Hartmann's reversal and medical in laparoscopic Hartmann's reversal.

Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Philadelphia, Pennsylvania, April 30 to May 5, 2005.

e-mail: sally.lutz@lvh.com

© The ASCRS 2008