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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 4/2010

Open Access 01-04-2010 | Review Article

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

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

Published in: Journal of Gastrointestinal Surgery | Issue 4/2010

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Abstract

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.
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Metadata
Title
Conventional and Laparoscopic Reversal of the Hartmann Procedure: a Review of Literature
Authors
Bryan Joost Marinus van de Wall
Werner A. Draaisma
Esther S. Schouten
Ivo A. M. J. Broeders
Esther C. J. Consten
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 4/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-1084-3

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