Hartmann’s procedure and laparoscopic reversal versus primary anastomosis and ileostomy closure for left colonic perforation

Abstract

Laparoscopic Hartmann's reversal is achievable in a high proportion of patients. Strategy B tends to have lower overall morbidity; meanwhile, major morbidity seems to be similar. Yet, in critically ill patients and in the absence of expertise of the surgeon on call, HP followed by elective laparoscopic reversal represents a viable alternative.

Resection with primary anastomosis vs nonrestorative resection for perforated diverticulitis with peritonitis: a systematic review and meta‐analysis

“…Eleven studies included patients with Hinchey III-IV diverticulitis only [15][16][17]25,[30][31][32][33][34][35][36], whereas six studies included patients with Hinchey < III [24,[26][27][28][29]37]. Articles not reporting outcomes for patients with Hinchey III-IV diverticulitis separately or not reporting the Hinchey class of the severity of peritonitis were excluded [38][39][40][41][42][43][44][45][46][47][48][49].The primary end-points of all included studies were mortality and postoperative morbidity. Studies stratified by reported end-points are presented in Data S2.…”

Reversal of Hartmann's Procedure: Evaluating Outcomes of Single-Port Laparoscopic Approach Versus Conventional Approach

“…After successful anastomosis, port sites are closed using non-absorbable sutures using the ostomy site approach and involves delayed closure, packing, and secondary intention [13][14][15]. Studies show that patients undergoing laparoscopic colostomy reversal have shown a reduced risk of complication compared to those who underwent OS [1,3,13,[16][17][18]. The locations of the trocar placement during the CL procedure can be seen clearly in…”

Primary anastomosis and suturing combined with vacuum-assisted abdominal closure in patients with secondary peritonitis due to perforation of the small intestine: A retrospective study

“…Intestinal resection to achieve source control and placement of a proximal stoma, with either closure of the distal intestinal segment or the placement of a distal stoma, is the conventional treatment of choice (5)(6)(7)(8)(9)(10). A primary anastomosis with a proximal protective diverting loop-ostomy may be an alternative option (11). This strategy involving stoma placement carries a risk of high stoma output, short-bowel syndrome, permanent stoma, or complications to a later reversal (6).…”