DOES TECHNIQUE MATTER? COMPARING LATERO-ANTERIOR AND END-TO-END ANASTOMOSIS IN HARTMANN’S REVERSAL giselaoropeza@outlook.com

411-06

DOES TECHNIQUE MATTER? COMPARING LATERO-ANTERIOR AND END-TO-END ANASTOMOSIS IN HARTMANN’S REVERSAL

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Billy Jiménez Bobadilla giselaoropeza@outlook.com Hospital General de México Coloproctology Ciudad de México Mexico

Mexico

Oral or Poster

Colorectal anastomosis can be performed using various techniques, with side-to-side and end-to-end configurations being the most commonly employed approaches to reestablish bowel continuity following resection. Each method presents unique technical characteristics and may influence postoperative outcomes differently.

: A retrospective, observational and analytical study was performed, including 55 patients with Hartmann's reversal procedure, in which colorectal anastomosis, latero-anterior or end-to-end, was performed

In a sample of 55 patients with colorectal anastomosis, clinical, biochemical and postoperative characteristics were compared between those with end-to-end (n=16) and latero-anterior (n=39) anastomosis. No statistically significant differences were observed in variables such as age (end-to-end: 46.3 ± 15.6 years vs. side-to-side: 51.9 ± 12.6 years; p=0.166), BMI, intraoperative bleeding, or preoperative albumin. Regarding inflammatory markers, C-reactive protein (CRP) values were consistently higher in the latero-anterior group on postoperative days 1, 3 and 5, although the differences did not reach statistical significance. Regarding complications, anastomotic leaks were documented in 3 patients with latero-anterior and in 4 with end-to-end (7.7% vs. 25%), without reaching statistical significance (p=0.080), but with a trend that could be clinically relevant. Likewise, the need for reintervention was more frequent in end-to-end (31.2%) compared to latero-anterior (10.3%), with a marginal difference (p=0.056).

Although the Side-to-Side technique had a longer mean operative time the End-to-End group showed a higher proportion of postoperative complications: anastomotic leakage, reintervention, and 30-day readmission. Although these differences did not reach statistical significance, they may indicate a clinically relevant trend that should be considered when selecting the surgical technique.