Publication

Conventional and Laparoscopic Reversal of the Hartmann Procedure: a Review of Literature

van de Wall, B. J. M., Draaisma, W. A., Schouten, E. S., Broeders, I. A. M. J. & Consten, E. C. J., Apr-2010, In : Journal of Gastrointestinal Surgery. 14, 4, p. 743-752 10 p.

Research output: Contribution to journalReview articleAcademicpeer-review

  • Bryan Joost Marinus van de Wall
  • Werner A. Draaisma
  • Esther S. Schouten
  • Ivo A. M. J. Broeders
  • Esther C. J. Consten

Purpose The aim of this study was to provide a systematic overview on both laparoscopic and conventional Hartmann reversal. Furthermore, the Hartmann procedure is reevaluated in the light of new emerging alternatives.

Methods Medline, Ovid, EMBASE, and Cochrane database were searched for studies reporting on outcomes after Hartmann reversal.

Results Thirty-five studies were included in this review of which 30 were retrospective. A total of 6,249 patients with a mean age of 60 years underwent Hartmann reversal. Two thirds of patients were classified as American Society of Anesthesiologists (ASA) I-II. The mean reversal rate after a Hartmann procedure was 44%, and mean time interval between Hartmann procedure and Hartmann reversal was 7.5 months. The most frequent reported reasons for renouncing Hartmann reversal were high ASA classification and patients' refusal. The overall morbidity rate ranged from 3% to 50% (mean 16.3%) and mortality rate from 0% to 7.1% (mean 1%). Patients treated laparoscopically had a shorter hospital stay (6.9 vs. 10.7 days) and appeared to have lower mean morbidity rates compared to conventional surgery (12.2% vs. 20.3%).

Conclusion Hartmann reversal carries a high risk on perioperative morbidity and mortality. The mean reversal rate is considerably low (44%). Laparoscopic reversal compares favorably to conventional; however, high level evidence is needed to determine whether it is superior.

Original languageEnglish
Pages (from-to)743-752
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume14
Issue number4
Publication statusPublished - Apr-2010
Externally publishedYes

    Keywords

  • Hartmann, Reversal, Morbidity, Mortality, INTESTINAL CONTINUITY, COLOSTOMY REVERSAL, ASSISTED REVERSAL, PRIMARY ANASTOMOSIS, LOOP ILEOSTOMY, COMPLICATIONS, RESTORATION, DIVERTICULITIS, EXPERIENCE, MORBIDITY

ID: 136491482