D Chavrier1,2, A Alves1,3,2, B Menahem4,5,6. 1. Department of Digestive Surgery, University Hospital of Caen, Avenue de La Côte de Nacre, 14032, Caen cedex, France. 2. Pôle de Formation Et de Recherche en Santé, Caen, France. 3. ANTICIPE INSERM U, 1086, Avenue du Général Harris, Centre François Baclesse, Caen, France. 4. Department of Digestive Surgery, University Hospital of Caen, Avenue de La Côte de Nacre, 14032, Caen cedex, France. menahem-b@chu-caen.fr. 5. ANTICIPE INSERM U, 1086, Avenue du Général Harris, Centre François Baclesse, Caen, France. menahem-b@chu-caen.fr. 6. Pôle de Formation Et de Recherche en Santé, Caen, France. menahem-b@chu-caen.fr.
Abstract
BACKGROUND: The aim of this study was to perform a systematic review of the literature on and updated meta-analysis of surgical postoperative complications after laparoscopic Hartmann's reversal (LHR) and open Hartmann's reversal (OHR). METHODS: Studies comparing LHR versus OHR published from inception until June 2020 were selected and submitted to a systematic review and meta-analysis. Articles were searched in the MEDLINE and Cochrane Trials Register databases. Meta-analysis was performed with Review Manager 5.0. RESULTS: Twenty-three retrospective comparative studies (including 5 case-controlled studies) with a total of 3139 patients with LHR and a total of 10,325 patients with OHR were included. Meta-analysis showed that LHR was significantly associated with a decreased rate of revision surgery (OR = 0.73, 95% CI = 0.60-0.89, p < 0.001), anastomotic leakage (OR = 0.61, 95% CI = 0.49-0.75, p < 0.00001), postoperative morbidity (OR = 0.53, 95% CI = 0.47-0.58, p < 0.00001), intra-abdominal abscess (OR = 0.67 [0.52-0.87], 95% CI = , p = 0.003), wound abscess (OR = 0.53 [0.46-0.61], 95% CI = , p < 0.00001), and postoperative ileus (OR = 0.46, 95% CI = 0.29-0.72, p = 0.0008), respectively. Conversely, mortality was comparable between LHR and OHR. CONCLUSIONS: These results suggest that LHR significantly improved surgical postoperative outcomes. However, considering the low level of evidence, further randomized trials are required to validate these findings.
BACKGROUND: The aim of this study was to perform a systematic review of the literature on and updated meta-analysis of surgical postoperative complications after laparoscopic Hartmann's reversal (LHR) and open Hartmann's reversal (OHR). METHODS: Studies comparing LHR versus OHR published from inception until June 2020 were selected and submitted to a systematic review and meta-analysis. Articles were searched in the MEDLINE and Cochrane Trials Register databases. Meta-analysis was performed with Review Manager 5.0. RESULTS: Twenty-three retrospective comparative studies (including 5 case-controlled studies) with a total of 3139 patients with LHR and a total of 10,325 patients with OHR were included. Meta-analysis showed that LHR was significantly associated with a decreased rate of revision surgery (OR = 0.73, 95% CI = 0.60-0.89, p < 0.001), anastomotic leakage (OR = 0.61, 95% CI = 0.49-0.75, p < 0.00001), postoperative morbidity (OR = 0.53, 95% CI = 0.47-0.58, p < 0.00001), intra-abdominal abscess (OR = 0.67 [0.52-0.87], 95% CI = , p = 0.003), wound abscess (OR = 0.53 [0.46-0.61], 95% CI = , p < 0.00001), and postoperative ileus (OR = 0.46, 95% CI = 0.29-0.72, p = 0.0008), respectively. Conversely, mortality was comparable between LHR and OHR. CONCLUSIONS: These results suggest that LHR significantly improved surgical postoperative outcomes. However, considering the low level of evidence, further randomized trials are required to validate these findings.
Authors: Jeanine Arkenbosch; Hiromichi Miyagaki; H M C Shantha Kumara; Xiaohong Yan; Vesna Cekic; Richard L Whelan Journal: Surg Endosc Date: 2014-11-01 Impact factor: 4.584
Authors: Anwar Medellin Abueta; Nairo Javier Senejoa; Mauricio Pedraza Ciro; Lina Fory; Carlos Perez Rivera; Carlos Edmundo Martinez Jaramillo; Lina Maria Mateus Barbosa; Heinz Orlando Ibañez Varela; Javier A Carrera; Rafael Garcia Duperly; Luis A Sanchez; Ivan David Lozada-Martinez; Luis Felipe Cabrera-Vargas; Andres Mendoza; Paulo Cabrera; Sebastian Sanchez Ussa; Cristian Paez; Steven D Wexner; Victor Strassmann; Giovanna DaSilva; Salomone Di Saverio; Arianna Birindelli; Roberto Jose Rodríguez Florez; Abraham Kestenberg; Alexander Obando Rodallega; Juan Carlos Sánchez Robles; Carlos Adrian Niño Carrasco; Alessio Impagnatiello; Diletta Cassini; Gianandrea Baldazzi; Francesco Roscio; Gianluca Liotta; Pierluigi Marini; Daniel Gomez; Carlos Edgar Figueroa Avendaño; Daniela Moreno Villamizar; Laura Cabrera; Juan Carlos Reyes; Alexis Narvaez-Rojas Journal: Health Sci Rep Date: 2022-09-01