Transanal and transabdominal laparoscopic Hartmann's reversal with rectal stump fistula management – a video vignette

2019 ◽  
Vol 22 (2) ◽  
pp. 227-228
Author(s):  
G. Dapri ◽  
A. Grilli ◽  
A. Arabadzhiev ◽  
N. A. Bascombe ◽  
K. Grozdev
Keyword(s):  
Rectal Stump ◽  
Hartmann’S Reversal ◽  
Video Vignette ◽  
Hartmann's Reversal

Laparoscopic Hartmann's reversal surgery in a complex abdomen - a video vignette

2018 ◽  
Vol 20 (7) ◽  
pp. 648-648
Author(s):  
T. B. Cengiz ◽  
S. R. Steele ◽  
C. P. Delaney ◽  
H. Kessler
Keyword(s):  
Hartmann’S Reversal ◽  
Video Vignette ◽  
Hartmann's Reversal

scholarly journals The Challenges of the Hartmann's Rectal Stump Reversal: A Clinical Audit and Review of the Literature

2018 ◽  
Vol 102 (9-10) ◽  
pp. 404-411
Author(s):  
Manpreet Sharma Rajcoomar ◽  
Suman Mewa Kinoo ◽  
Ruvashni Naidoo ◽  
Nikesh Sewkurren ◽  
Bhugwan Singh
Keyword(s):  
Imaging Modality ◽  
Rectal Stump ◽  
Hartmann’S Procedure ◽  
Preoperative Imaging ◽  
High Ligation ◽  
Imaging Evaluation ◽  
Hartmann’S Reversal ◽  
Hartmann's Procedure ◽  
Significant Incidence ◽  
Hartmann's Reversal

Background: Hartmann's procedure is performed in patients who are not candidates for immediate reestablishment of colonic continuity. A shrunken rectal stump poses a great challenge at the time of its reversal. Objective: To determine the factors [level of inferior mesenteric artery (IMA) ligation and duration prior to Hartmann's reversal] contributing to a shrunken rectal stump. The value of imaging and success rate of the technique used in the Hartmann's reversal were also assessed. Methods: A retrospective analysis of 36 patients who underwent Hartmann's procedure and reversal between 2012 and 2014 was performed. Patient demographic profile, initial pathology, operation setting, level of IMA ligation, complications, duration prior to reversal, imaging modality, state of rectal stump, outcome, and reversal technique were documented. Results: Thirty-six patients were considered for reversal of Hartmann's procedure. In 95.5% of subjects who underwent a high IMA ligation, proximal rectum stricture and short, shrunken rectal stumps were noted. Patients who underwent reversal after 6 months had a significant incidence of a short shrunken rectal stump (n = 19; 82.6%). The percentage of successful outcomes in the reversal of the short rectal stump using the stapling technique was 93.8% (n = 27). Twenty-six patients who underwent barium enema correlated strongly with the operation findings. Conclusion: High ligation in Hartmann's procedure contributes to a short shrunken rectal stump. The duration prior to reversal of more than 6 months correlates with a shrunken rectal stump. Preoperative imaging evaluation serves as a good predictor for the length of the rectal stump. A staples anastomotic technique shows good outcome.

Laparoscopic Hartmann’s reversal: a step‐by‐step video demonstration – a video vignette

2020 ◽  
Vol 22 (10) ◽  
pp. 1462-1463
Author(s):  
G. Pellino ◽  
M. Adell Trape ◽  
F. Marinello ◽  
M. Martí Gallostra ◽  
E. Espín‐Basany
Keyword(s):  
Hartmann’S Reversal ◽  
Video Demonstration ◽  
Video Vignette ◽  
Hartmann's Reversal

scholarly journals Reversión operación de Hartmann por vía laparoscópica

2021 ◽  
Author(s):  
Marcelo Viola Malet
Keyword(s):  
Multicenter Study ◽  
Open Surgery ◽  
Hartmann’S Procedure ◽  
Efficacy And Safety ◽  
Hartmann Procedure ◽  
Free Survival ◽  
Hartmann’S Reversal ◽  
Hartmann's Procedure ◽  
Colostomy Reversal ◽  
Hartmann's Reversal

Introducción. El procedimiento de Hartmann es una de las cirugías que se realizan con mayor frecuencia frente a una complicación oclusiva o perforativa de colon izquierdo; nos permite resolver el cuadro clínico de la complicación. El porcentaje de restitución del tránsito intestinal es muy bajo, promedialmente inferior al 50%. Ésto se debe a factores propios del paciente, la morbimortalidad de la cirugía, y a dificultades técnicas. El reestablecimiento del tránsito intestinal luego de un Hartmann puede llegar a ser una cirugía muy hostil. Tiene una morbilidadmortalidad propia no despreciable, independientemente de la vía de abordaje utilizada. La reversión por laparoscopía es uno de los procedimientos más complejos a realizar mediante este abordaje. Pero varios estudios han demostrado, que si bien requiere de una curva de aprendizaje más larga y un nivel de destreza técnica alto, tiene mejores resultados que el laparotómico.   Descripción. Presentamos el caso clínico de un hombre de 65 años, que consultó por una peritonitis purulenta diverticular un año atrás, al cual se le realizó una procedimiento de Hartmann. Se coordina para reconstrucción del tránsito intestinal por vía laparoscópica. Paciente en decúbito dorsal, Trendelemburg 30º y lateralizado a derecha. Neumoperitoneo hasta 12mmHg por técnica abierta en flanco derecho para un puerto de 12mm, inicialmente para la cámara, y luego para la mano izquierda del cirujano. Otro de 6mm en fosa ilíaca derecha para la mano derecha del cirujano, y  uno de 12mm supraumbilical para la cámara. Identificamos el muñón rectal en la pelvis. Liberamos el ostoma circunferencialmente, y confeccionamos una jareta con polipropileno 2-0. Colocacamos el anvil de la sutura mecánica 29mm, y reintroducimos el cabo colónico al abdomen. Se realiza cierre parietal en dos planos, y reinstalamos el neumoperitoneo. Colocacamos la sutura mecánica transrectal, engarzando la misma con el anvil a través de la cara anterior del muñón rectal, confeccionando la anastomosis colo-rectal término-lateral. La prueba hidroneumática fue negativa. El paciente tuvo un postoperatorio sin complicaciones, otorgándole el alta a las 72hs del procedimiento, tolerando vía oral, sin dolor, sin fiebre y habiendo movilizado el intestino.   Conclusiones. La cirugía de Hartmann sigue siendo uno de los procedimiento más realizados para tratar las complicaciones perforativas y oclusivas del colon izquierdo y recto. La restitución del tránsito intestinal luego de esta cirugía tiene un altísimo porcentaje de no concretarse por diferentes motivos. La cirugía miniinvasiva requiere de una larga curva de aprendizaje y destreza de alto nivel, pero hay varios trabajos que demuestran que la reversión de un Hartmann tiene mejores resultados por esta vía.   Bibliografía Hallam S, Mothe BS, Tirumulaju R. Hartmann's procedure, reversal and rate of stoma-free survival. Ann R Coll Surg Engl. 2018;100(4):301-307. doi:10.1308/rcsann.2018.0006 Horesh N, Lessing Y, Rudnicki Y, et al. Considerations for Hartmann's reversal and Hartmann's reversal outcomes-a multicenter study. Int J Colorectal Dis. 2017;32(11):1577-1582. doi:10.1007/s00384-017-2897-2 Melkonian E, Heine C, Contreras D, et al. Reversal of the Hartmann's procedure: A comparative study of laparoscopic versus open surgery. J Minim Access Surg. 2017;13(1):47-50. doi:10.4103/0972-9941.181329 Resio BJ, Jean R, Chiu AS, Pei KY. Association of Timing of Colostomy Reversal With Outcomes Following Hartmann Procedure for Diverticulitis. JAMA Surg. 2019;154(3):218-224. doi:10.1001/jamasurg.2018.4359 Park W, Park WC, Kim KY, Lee SY. Efficacy and Safety of Laparoscopic Hartmann Colostomy Reversal. Ann Coloproctol. 2018;34(6):306-311. doi:10.3393/ac.2018.09.07

Hartmann’s reversal as a safe procedure for selected patients: analysis of 199 patients at a high-volume center in Sao Paulo

Surgery Today ◽  
2020 ◽  
Vol 50 (8) ◽  
pp. 855-862
Author(s):  
Alberto Bitran ◽  
Roberto Rasslan ◽  
Fabio de Oliveira Ferreira ◽  
Edivaldo Massazo Utiyama ◽  
Samir Rasslan
Keyword(s):  
High Volume ◽  
Sao Paulo ◽  
Safe Procedure ◽  
São Paulo ◽  
Hartmann’S Reversal ◽  
High Volume Center ◽  
Hartmann's Reversal

Trans-stomal single-port laparoscopic Hartmann’s reversal is an efficacious and efficient procedure: a case-controlled study

2020 ◽  
Vol 24 (5) ◽  
pp. 455-462 ◽  
Author(s):  
A. D’Alessandro ◽  
A. A. Gumbs ◽  
M. Cartillone ◽  
N. Elkary ◽  
E. Chahine ◽  
...  
Keyword(s):  
Single Port ◽  
Controlled Study ◽  
Efficient Procedure ◽  
Hartmann’S Reversal ◽  
Hartmann's Reversal

Hartmann’s reversal: factors affecting complications and outcomes

2020 ◽  
Vol 35 (10) ◽  
pp. 1875-1880 ◽  
Author(s):  
Stewart Whitney ◽  
Benjamin D. Gross ◽  
Alex Mui ◽  
Sue Hahn ◽  
Blake Read ◽  
...  
Keyword(s):  
Factors Affecting ◽  
Hartmann’S Reversal ◽  
Hartmann's Reversal

Application of a Tertiary Referral Scoring System to Predict Nonreversal of Hartmann's Procedure for Diverticulitis in a Community Hospital

2011 ◽  
Vol 77 (7) ◽  
pp. 814-819 ◽  
Author(s):  
Sachin Vaid ◽  
Joshua Wallet ◽  
Jeff Litt ◽  
Ted Bell ◽  
Rod Grim ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Scoring System ◽  
Community Hospital ◽  
Acute Diverticulitis ◽  
Cleveland Clinic ◽  
Hospital Setting ◽  
Hartmann’S Procedure ◽  
Hartmann’S Reversal ◽  
Hartmann's Procedure ◽  
Hartmann's Reversal

Riansuwan et al. at Cleveland Clinic developed a scoring system to quantify the risk of Hartmann's nonreversal based on age, preoperative transfusion, pulmonary comorbidity, American Society of Anesthesiologists score, perforation, and anticoagulation. Our study validates the scoring system in a community hospital setting. Patients undergoing Hartmann's procedure for diverticulitis (2006 to June 2009) were identified from our hospital's database. Two groups were formed based on Hartmann's reversal within 1 year and those with nonreversal. An independent-sample t test and logistic regression using score and nine other variables as predictors of Hartmann's non-reversal were run. Sixty-three of 93 patients (67.7%) had a Hartmann's reversal. Higher scores and higher mean age were seen in the nonreversal group (15.5 ± 3.0 vs 12.1 ± 2.5 and 73 ± 15 vs 63 ± 14 years, respectively). Patients with scores 18 or above were not reversed; 43 of 49 patients (88%) with scores of 13 or less were reversed. Logistic regression confirmed that the only predictive variable for nonreversal is a higher score. The scoring system is predictive of nonreversibility of Hartmann's procedure for acute diverticulitis. This will be useful in allowing surgeons to strategize accurately and to counsel patients realistically. Higher scores may allow both the surgeon and patient to have a low threshold for exploring alternatives to Hartmann's procedure.

Laparoscopic versus open Hartmann’s reversal: a systematic review and meta-analysis

2015 ◽  
Vol 30 (12) ◽  
pp. 1603-1615 ◽  
Author(s):  
Valerio Celentano ◽  
Mariano Cesare Giglio ◽  
Luigi Bucci
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Hartmann’S Reversal ◽  
Hartmann's Reversal
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