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Laparoscopic versus open Hartmann reversal: a propensity score matching analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to compare the short-term outcomes between laparoscopic Hartmann reversal (LHR) and open Hartmann reversal (OHR) in patients who had undergone Hartmann surgery for colorectal cancer (CRC).

Methods

The patients who underwent Hartmann reversal (HR) at the First Affiliated Hospital of Chongqing Medical University from Jun 2013 to Jun 2022 were retrospectively enrolled. The LHR group and the OHR group were compared using propensity score matching (PSM) analysis.

Results

A total of 89 patients who underwent Hartmann reversal (HR) were enrolled in this study. There were 48 (53.9%) patients in the LHR group and 41 (46.1%) patients in the OHR group. After 1:1 ratio PSM, no difference in baseline information remained (p > 0.05). There was no significant difference in operation time, blood loss, postoperative hospital stay, and postoperative complications (p > 0.05) before and after PSM. In the multivariable logistic regression analysis, pre-operative albumin < 42.0 g/L was an independent risk factor (p = 0.013 < 0.05, OR = 0.248, 95% CI = 0.083–0.741) for the HR-related complications; however, LHR/OHR was not a predictive risk factor (p = 0.663, OR = 1.250, 95% CI = 0.500–3.122).

Conclusion

Based on the current evidence, although there was no difference in short-term prognosis, LHR still had some advantages considering that it was less invasive to the patient.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Sung H et al (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660

    Article  PubMed  Google Scholar 

  2. Xia C et al (2022) Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl) 135(5):584–590. https://doi.org/10.1097/CM9.0000000000002108

    Article  PubMed  Google Scholar 

  3. Liu XY et al (2022) The short-term and oncologic outcomes of younger VS older colorectal cancer patients undergoing primary surgery: a propensity score matching analysis. BMC Cancer 22(1):153. https://doi.org/10.1186/s12885-022-09246-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Peng D, Cheng YX, Cheng Y (2021) Improved overall survival of colorectal cancer under multidisciplinary team: a meta-analysis. Biomed Res Int 2021:5541613. https://doi.org/10.1155/2021/5541613

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lavanchy JL et al (2019) Oncologic long-term outcomes of emergency versus elective resection for colorectal cancer. Int J Colorectal Dis 34(12):2091–2099. https://doi.org/10.1007/s00384-019-03426-8

    Article  PubMed  Google Scholar 

  6. Ascanelli S et al (2003) Early and late outcome after surgery for colorectal cancer: elective versus emergency surgery. Tumori 89(1):36–41. https://doi.org/10.1177/030089160308900108

    Article  PubMed  Google Scholar 

  7. Hartmann H (1921) Nouveau procédé d’ablation des cancers de la partie terminale du colon pelvien. in Trentieme Congres de Chirurgie

  8. Tsuchiya A et al (2018) Mortality and morbidity after Hartmann’s procedure versus primary anastomosis without a diverting stoma for colorectal perforation: a nationwide observational study. World J Surg 42(3):866–875. https://doi.org/10.1007/s00268-017-4193-2

    Article  PubMed  Google Scholar 

  9. Vermeulen J et al (2010) Avoiding or reversing Hartmann’s procedure provides improved quality of life after perforated diverticulitis. J Gastrointest Surg 14(4):651–657. https://doi.org/10.1007/s11605-010-1155-5

    Article  PubMed  PubMed Central  Google Scholar 

  10. Roe AM et al (1991) Reversal of Hartmann’s procedure: timing and operative technique. Br J Surg 78(10):1167–1170. https://doi.org/10.1002/bjs.1800781006

    Article  CAS  PubMed  Google Scholar 

  11. Kang JH et al (2020) Analysis of factors affecting reversal of Hartmann’s procedure and post-reversal complications. Sci Rep 10(1):16820. https://doi.org/10.1038/s41598-020-73791-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Carus T, Bollmann S, Lienhard H (2008) Laparoscopic reversal of Hartmann’s procedure: technique and results. Surg Laparosc Endosc Percutan Tech 18(1):24–28. https://doi.org/10.1097/SLE.0b013e31815b3233

    Article  PubMed  Google Scholar 

  13. Chen Z, Nair N, Hanif U (2021) Outcomes of laparoscopic vs. open reversal of Hartmann’s procedure: a single centre experience. Cureus 13(8):e17242. https://doi.org/10.7759/cureus.17242

  14. Mirza KL et al (2021) Outcomes of colostomy takedown following Hartmann’s procedure: successful restoration of continuity comes with a high risk of morbidity. Colorectal Dis 23(4):967–974. https://doi.org/10.1111/codi.15456

    Article  PubMed  Google Scholar 

  15. Park W et al (2018) Efficacy and safety of laparoscopic Hartmann colostomy reversal. Ann Coloproctol 34(6):306–311. https://doi.org/10.3393/ac.2018.09.07

    Article  PubMed  PubMed Central  Google Scholar 

  16. Yang PF, Morgan MJ (2014) Laparoscopic versus open reversal of Hartmann’s procedure: a retrospective review. ANZ J Surg 84(12):965–969. https://doi.org/10.1111/ans.12667

    Article  PubMed  Google Scholar 

  17. Zimmermann M et al (2014) Laparoscopic versus open reversal of a Hartmann procedure: a single-center study. World J Surg 38(8):2145–2152. https://doi.org/10.1007/s00268-014-2507-1

    Article  PubMed  Google Scholar 

  18. Sato A et al (2022) Comparison of outcomes between laparoscopic and open Hartmann’s reversal: a single-center retrospective study in Japan. Asian J Endosc Surg 15(1):137–146. https://doi.org/10.1111/ases.12982

    Article  PubMed  Google Scholar 

  19. Cho HJ, Kim WR, Kim JW (2021) A comparative study between open versus laparoscopic Hartmann reversal: a single-center experience and analysis. Medicine (Baltimore) 100(47):e27976. https://doi.org/10.1097/MD.0000000000027976

  20. Panaccio P et al (2021) Laparoscopic versus open Hartmann reversal: a case-control study. Surg Res Pract 2021:4547537. https://doi.org/10.1155/2021/4547537

    Article  PubMed  PubMed Central  Google Scholar 

  21. Whitney S et al (2020) Hartmann’s reversal: factors affecting complications and outcomes. Int J Colorectal Dis 35(10):1875–1880. https://doi.org/10.1007/s00384-020-03653-4

    Article  PubMed  Google Scholar 

  22. Kwak HD et al (2018) Hartmann’s reversal: a comparative study between laparoscopic and open approaches. ANZ J Surg 88(5):450–454. https://doi.org/10.1111/ans.13979

    Article  PubMed  Google Scholar 

  23. Onder A et al (2016) Comparison of short-term outcomes after laparoscopic versus open Hartmann reversal: a case-matched study. Surg Laparosc Endosc Percutan Tech 26(4):e75–e79. https://doi.org/10.1097/sle.0000000000000299

    Article  PubMed  Google Scholar 

  24. McArdle CS, Hole DJ (2004) Emergency presentation of colorectal cancer is associated with poor 5-year survival. Br J Surg 91(5):605–609. https://doi.org/10.1002/bjs.4456

    Article  CAS  PubMed  Google Scholar 

  25. Fonseca AZ et al (2017) Colostomy closure: risk factors for complications. Arq Bras Cir Dig 30(4):231–234. https://doi.org/10.1590/0102-6720201700040001

    Article  PubMed  PubMed Central  Google Scholar 

  26. Paik B et al (2018) Postoperative outcomes of stoma takedown: results of long-term follow-up. Ann Coloproctol 34(5):266–270. https://doi.org/10.3393/ac.2017.12.13

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sherman KL, Wexner SD (2017) Considerations in stoma reversal. Clin Colon Rectal Surg 30(3):172–177. https://doi.org/10.1055/s-0037-1598157

    Article  PubMed  PubMed Central  Google Scholar 

  28. Moghadamyeghaneh Z et al (2015) Even modest hypoalbuminemia affects outcomes of colorectal surgery patients. Am J Surg 210(2):276–284. https://doi.org/10.1016/j.amjsurg.2014.12.038

    Article  PubMed  Google Scholar 

  29. Rytter MJ et al (2014) The immune system in children with malnutrition--a systematic review. PLoS One 9(8):e105017. https://doi.org/10.1371/journal.pone.0105017

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Acknowledgements

The authors are grateful to all the colleagues who helped in the preparation of this article.

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Author notes

  1. Li Tan, Xiao-Yu Liu, and Bin Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    Li Tan, Xiao-Yu Liu, Bin Zhang, Lian-Lian Wang, Zheng-Qiang Wei & Dong Peng

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  1. Li Tan
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Contributions

All authors contributed to data collection; Dong Peng contributed to the data analysis, Dong Peng led the quality assessments; Li Tan, Bin Zhang, and Xiao-Yu Liu wrote the original draft; and Li Tan, Lian-Lian Wang, and Zheng-Qiang Wei revised the manuscript. All the authors have agreed on the manuscript that will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Dong Peng.

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Ethics approval and consent to participate

Ethical approval from the institutional review board of the First Affiliated Hospital of Chongqing Medical University was obtained (2021–519) and all patients signed informed consent forms.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Tan, L., Liu, XY., Zhang, B. et al. Laparoscopic versus open Hartmann reversal: a propensity score matching analysis. Int J Colorectal Dis 38, 22 (2023). https://doi.org/10.1007/s00384-023-04320-0

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