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Oral presentation
OP1.04

Laparoscopic Hartmann's procedure is a safe and effective alternative for emergent surgical management of complicated diverticulitis: A NSQIP-based, propensity score matched analysis study

Appointment

Date: 07/05/2023

Time: 08:48 – 08:57

Talk time: 7 Min.

Discussion time: 2 Min.

Location / Stream:

E 2

Session

Free Oral Presentations 1

Topic

Emergency surgery

Authors

Leo Amodu (Mineola, NY / US), Hazim Hakmi (Mineola, NY / US), Amir Sohail (Mineola, NY / US), Meredith Akerman (Mineola, NY / US), Toyooki Sonoda (Mineola, NY / US), Patrizio Petrone (Mineola, NY / US), David Halpern (Mineola, NY / US)

Abstract

Abstract text (incl. references and figure legends)

Introduction: As many as 25% of patients with acute diverticulitis will present with complicated disease. The procedure of choice for emergent management of complicated diverticulitis has been the open Hartmann"s procedure. We analyzed the NSQIP database to compare outcomes in patients who underwent emergent laparoscopic Hartmann"s procedure for complicated diverticulitis to those who had an open Hartmann"s procedure.

Methods: Data analyzed was from the ACS-NSQIP database. We identified patients with complicated colonic diverticulitis using ICD-10 codes, and who required either a laparoscopic or open Hartmann"s procedure from 2015 - 2019. Propensity score method (PSM) was utilized to match patients in each of the two surgical groups on several important covariates.

Results: Prior to PSM analysis, 4,570 patients had an open Hartmann"s procedure, while 456 had laparoscopic Hartmann"s procedure from 2015 to 2019. PSM analysis based on the aforementioned covariates yielded 374 open Hartmann"s and 374 laparoscopic Hartmann"s patients. Laparoscopic Hartmann"s patients had similar post-operative outcomes when compared to open, including mortality (5.08% vs. 4.55%; p=0.8642), wound disruption (1.34% vs. 1.6%; p=1.0), superficial surgical site infections (SSSI) (2.41% vs. 5.35%; p=0.0614), median LOS (10.5 d vs. 10.6 days; p=0.9630), any readmission within 30 days (11.76% vs. 9.63%; p=0.4282). Laparoscopic Hartmann"s procedures were slightly longer compared to open, (median procedure time; 129 vs. 116.5 minutes).

Conclusion: Laparoscopic Hartmann"s procedure is a safe and effective alternative to open Hartmann"s procedure for emergent surgical management of complicated diverticulitis. More studies are needed to determine differences in long-term outcomes between these two procedures.

Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)

No.