Abstract
Bowel restoration following Hartmann's procedure (HP) remains a topic of discussion and innovation. This article seeks to highlight and analyze the outcomes of conventional reversal approaches such as open surgery (OS) and conventional laparoscopic (CL) to single-port laparoscopic reversal (SPLR) approach to evaluate whether SPLR is a feasible alternative to the OS or CL approach. A PubMed search using keywords yielded 5,750 articles. After applying the inclusion/exclusion criteria, 40 articles of relevance were reviewed, and endpoints considered. These included 13 systematic reviews and 27 observational reviews, three of which identified themselves as retrospective or comparative studies. The analysis showed overwhelming support for CL over OS as a choice for HP reversal. Studies comparing SPLR to CL showed SPLR to be a safe and feasible alternative, given its significantly shorter operating times, hospitalization times, and complication rates.
Highlights
BackgroundThe first description of Hartmann's procedure (HP) was in 1921, introduced by Henry Albert Hartmann, a French surgeon, and its primary intention was rectal carcinoma resection, this approach was taken in various diverticular diseases [1,2,3]
The analysis showed overwhelming support for conventional laparoscopic (CL) over open surgery (OS) as a choice for HP reversal
A total of 1209, according to Table 1 keyword searches, were removed due to one or more of the following reasons. They did not involve or specify the procedure of interest
Summary
BackgroundThe first description of Hartmann's procedure (HP) was in 1921, introduced by Henry Albert Hartmann, a French surgeon, and its primary intention was rectal carcinoma resection, this approach was taken in various diverticular diseases [1,2,3]. Colostomy reversal has been a topic of discussion aimed at reducing morbidity and mortality rates [5,6]. While conventional approaches of Hartmann's reversal [HR] such as open surgery (OS) and conventional laparoscopic (CL) surgery have been preferred, laparoscopic approaches have become increasingly favored by many for its reduced postoperative morbidity, wound infection, length of stay, and ileus formation. Since first being reported in 2011, the use of a single-port laparoscopic reversal (SPLR) technique has been explored. SPLR has been found safe and feasible via the colostomy site and maybe a considered surgical option for experienced surgeons in selected patients [7]. Thambi et al noted that compared to OS and CL, SPLR had shorter operating times and hospitalization, with no discernible difference in morbidity [8]. This article seeks to highlight the outcomes between CL and SPLR techniques to evaluate whether SPLR is a feasible alternative to the CL approach
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