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International Journal of Colorectal Disease

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22.11.2022 | Review

Open versus laparoscopic Hartmann’s procedure: a systematic review and meta-analysis

verfasst von: Yingjia Zhang, Chunxi Liu, Kameswara Rishi Yeshayahu Nistala, Choon Seng Chong

Erschienen in: International Journal of Colorectal Disease | Ausgabe 12/2022

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Abstract

Purpose

Hartmann’s procedure is traditionally performed in emergency situations where single-step procedures with immediate anastomosis may be unsafe. However, it can be associated with significant morbidity and low colostomy reversal rate. Whilst randomised controlled trials and a Cochrane review have reported strong evidence of laparoscopic over open colectomies, no such reviews have been performed for Hartmann’s procedure. Hence, this paper aims to summarise the existing evidence to determine the efficacy of laparoscopic Hartmann’s procedure over its open counterpart.

Methods

Embase, Medline and Cochrane databases were searched from inception to 15 November 2020 for keywords relating to ‘laparoscopy’ and ‘Hartmann’ using strict inclusion and exclusion criteria. Odds ratio was estimated for dichotomous outcomes and weighted mean difference was estimated for continuous outcomes.

Results

From the 836 articles yielded from the search strategy, 12 articles were selected for meta-analysis. Pooled analysis revealed that laparoscopic Hartmann’s procedure (LHP) allows for a shorter length of stay, and a lower risk of overall surgical site infections and superficial surgical site infections. There was no significant difference in other outcomes. Single-arm analysis of LHP also showed an unprecedented high colostomy reversal rate of over 80%.

Conclusion

In clinically suitable patients, laparoscopic Hartmann’s procedure has benefits over open Hartmann’s procedure. Despite the selection bias of single-arm studies, LHP has reported a high stoma reversal rate of over 80%. Future well-controlled studies should be done to affirm the findings.

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Titel: Open versus laparoscopic Hartmann’s procedure: a systematic review and meta-analysis
verfasst von: Yingjia Zhang
Chunxi Liu
Kameswara Rishi Yeshayahu Nistala
Choon Seng Chong
Publikationsdatum: 22.11.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Colorectal Disease / Ausgabe 12/2022
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-022-04285-6

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Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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