Reversal of left-sided colostomy utilizing single-port laparoscopy a multicenter European audit and overview of the literature

Surg Endosc. 2022 May;36(5):3389-3397. doi: 10.1007/s00464-021-08657-x. Epub 2021 Jul 26.

Abstract

Background: Stoma reversal surgery can result in considerable morbidity and even mortality. Feasibility of utilizing single-port laparoscopy through the stoma fenestration have been shown before. Aim of the present observational study is to evaluate multicenter experiences of single-port reversal of left-sided colostomy (SPRLC) throughout Europe and to provide an overview of available literature on this topic.

Methods: All patients undergoing SPRLC in four different teaching hospitals throughout Europe are included. Primary outcome was 30-day postoperative complication rate. Secondary outcomes were postoperative length of stay (LOS), single-port success rate and conversion rates. Appraisal of the available literature in PubMed was performed.

Results: Of 156 SPRLC procedures, 98.7% of them were technically successful and 71.8% were without postoperative complications. No postoperative mortality was encountered. Superficial site infection occurred in 14.7%, anastomotic leakage in 3.9% and major complications in 8.3%. Median LOS was 4.0 days (1-69), single-port success rate was 64.7%, 12.8% and 21.2% (33/154) were converted to an open and multiport laparoscopic procedure, respectively. Literature shows equally favorable results in 131 patients divided over 5 cohorts with morbidity ranging from 0 to 30.4% and mortality from 0 to 2.2% and median LOS of 4-8 days.

Conclusion: This study confirms the safety, feasibility and favorable results of the use of single-port approach in the reversal of left-sided colostomy in different centers in Europe with laparoscopic experienced colorectal surgeons. The available literature on this topic support and show equally favorable results using single-port laparoscopy for left-sided colostomy reversal surgery.

Keywords: Hartmann reversal; Hartmann’s procedure; Single-incision; Single-port laparoscopy; Stoma reversal.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Anastomosis, Surgical / methods
  • Colostomy / methods
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Surgical Stomas*