Complication rates after Hartmann's reversal: open vs. laparoscopic approach.
OBJECTIVE
This study was performed to compare open Hartmann's reversal to laparoscopic Hartmann's reversal with regard to complication, readmission, and reoperation rates.


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


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.
Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Christopher
C
Haughn
Brian
B
Ju
Miro
M
Uchal
Jean Pierre
JP
Arnaud
James F
JF
Reed
Roberto
R
Bergamaschi
D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D016737:Proctocolectomy, Restorative / Q000379:methods*; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome