Comparison of the risk of postoperative wound infection in patients with rectal cancer by laparoscopic versus open Hartmann's surgery

Abstract

AbstractTraditional Hartmann surgery is used when the patient is in an acute case where it might not be safe to carry out a one‐stage intestinal anastomosis. Laparoscopy has been extensively applied in the treatment of large intestine, which can significantly improve both short‐ and long‐term outcomes. While randomized, controlled studies and reviews have shown that laparoscopy is superior to that of open‐access colectomy, the impact of Hartmann's surgery on postoperative site infections has not been studied. The purpose of this study is to summarize the existing evidence to show that laparoscopy is better than open operation in the area of injury. Methods The Embase, PubMed and Cochrane Libraries were searched from the moment the database was created until November 2023. For binary results, the odds ratio was estimated, and a weighted average of consecutive results was calculated. Our findings indicate that there is a lower risk for SSIs after laparoscopic approach surgery than an open‐access procedure (OR, 0.26; 95% CI, 0.10, 0.69, p = 0.006); Laparoscopy was associated with a reduction in the risk of dying after surgery (OR, 0.50; 95% CI, 0.30, 0.84, p = 0.009); The operation time was not significantly different in open and laparoscope (MD, 12.23; 95% CI, −5.63, 30.09, p = 0.18); laparoscopy was used to lower the incidence of SSI after surgery and to lower the mortality rate after surgery than by open‐access surgery. However, the time of operation did not differ significantly among the two methods. However, further controlled trials will need to be carried out to verify the results.