PURPOSE: Emergency surgical strategies for acute left-sided @entity694 are evolving preferring primary @entity254 (PA) with ileostomy to @entity12870 ( @entity12870 ) based on the morbidity and reversal rates. However, @entity12870 is still commonly performed. Hartmann's reversal is associated with considerable morbidity. It is of interest whether laparoscopic reversal results in a lower morbidity as retrospective data suggest. Here, we compared the combined morbidity rates for two surgical strategies: strategy A, @entity12870 followed by laparoscopic reversal, and strategy B, sigmoid resection with PA followed by @entity2747 . METHODS: Prospectively collected data of all consecutive @entity1 undergoing @entity12870 for benign left-sided @entity694 between 2010 and 2014 were retrospectively compared to data of @entity1 undergoing PA. Groups were matched for age and Charlson comorbidity index. Additionally, @entity1 were analyzed for American Society of Anesthesiologists score, body mass index, and @entity298 stage. End points were morbidity, operation time, reversal rate, time to reversal, and length of hospital stay. RESULTS: The study included 32 @entity1 for whom Hartmann's reversal was planned, along with 32 matched @entity1 who underwent PA and diverting ileostomy. Median age was 75 and 72  years, Charlson score was 6 (4-9) and 6 (5-7), and @entity1 classified by the American Society of Anesthesiologists (ASA) higher than III were 81  % in both groups. Combined major morbidity rates were 21  % for strategy A and 20  % for strategy B (p   =   1.0). Combined comprehensive complication index was 16.4        14.1 and 12.3        19.1 (p   =   0.08). @entity12870 reversal by laparoscopy was achieved in 71  %. The colostomy reversal rate was 75  % compared to @entity2747 rate of 88  % (p   =   0.34). CONCLUSIONS: Laparoscopic Hartmann's reversal is achievable in a high proportion of @entity1 . Strategy B tends to have lower overall morbidity; meanwhile, major morbidity seems to be similar. Yet, in @entity3124 @entity1 and in the absence of expertise of the surgeon on call, @entity12870 followed by elective laparoscopic reversal represents a viable alternative.

@entity12870 and laparoscopic reversal versus primary @entity254 and @entity2747 for left XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity298 :: ('MESH:D010538', 'Disease') :: ['peritonitis'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity3124 :: ('MESH:D016638', 'Disease') :: ['critically ill'] @entity694 :: ('MESH:D003110', 'Disease') :: ['colonic perforation'] @entity12870 :: ('MESH:D055191', 'Disease') :: ['HP', "Hartmann's procedure"] @entity2747 :: ('MESH:D015812', 'Disease') :: ['ileostomy closure']
@entity694 :: (MESH:D003110,Disease) :: ['colonic perforation']
