Laparoscopically Assisted Reversal of Hartmann's Procedure for Perforated Diverticulitis

The aim of this study was to retrospectively review the clinical outcomes of laparoscopically assisted and open surgical reversal of Hartmann's procedure (HR). We reviewed all patients undergoing laparoscopic or open HR at Tri-Service General Hospital, Taipei, Taiwan, between January 2002 and January 2010. A total of 34 perforated diverticulitis patients initially treated by exploratory laparotomy with Hartmann's procedure were enrolled and divided into 2 groups: laparoscopic and open HR. Data relative to patient age at the time of HR, sex, body mass index, operative time, longest incision length, estimated blood loss, intraoperative complications, postoperative complications, time to bowel function return, duration of hospitalization, and length of follow-up were reviewed. The median colostomy closure period was significantly higher in the laparoscopic group than in the open group (P = 0.011). The median longest incision length, estimated blood loss, time to first oral intake, and hospital stay were significantly lower in the laparoscopic group compared with the open group. Laparoscopic HR may be a technically safe, feasible approach that provides better cosmesis, less blood loss, and faster recovery compared with open HR.