Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

2005 ◽  
Vol 22 (6) ◽  
pp. 419-425 ◽  
Author(s):  
J.L.T. Oomen ◽  
M.A. Cuesta ◽  
A.F. Engel
Keyword(s):  
Diverticular Disease ◽  
Sigmoid Colon ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure

Robotic Reversal of Hartmann's Procedure

2021 ◽  
Vol 34 (05) ◽  
pp. 325-327
Author(s):  
Ovunc Bardakcioglu
Keyword(s):  
Sigmoid Colon ◽  
Gold Standard ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Bowel Continuity

AbstractThe Hartmann's procedure first described in 1920 is a gold standard for a variety of emergent procedures of the sigmoid colon. A standardized approach to a robotic reversal of a Hartmann's procedure is described to reestablish bowel continuity.

scholarly journals State-of-the-art surgery for sigmoid diverticulitis

2021 ◽  
Author(s):  
Roberto Cirocchi ◽  
Paolo Sapienza ◽  
Gabriele Anania ◽  
Gian Andrea Binda ◽  
Stefano Avenia ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Fluid Resuscitation ◽  
State Of The Art ◽  
Colonic Resection ◽  
Hartmann’S Procedure ◽  
Sigmoid Diverticulitis ◽  
Definitive Treatment ◽  
Complication Rates ◽  
Bridge To Surgery ◽  
Hartmann's Procedure

Summary Background In the last two decades, there has been a Copernican revolution in the decision-making for the treatment of Diverticular Disease. Purpose This article provides a report on the state-of-the-art of surgery for sigmoid diverticulitis. Conclusion Acute diverticulitis is the most common reason for colonic resection after cancer; in the last decade, the indication for surgical resection has become more and more infrequent also in emergency. Currently, emergency surgery is seldom indicated, mostly for severe abdominal infective complications. Nowadays, uncomplicated diverticulitis is the most frequent presentation of diverticular disease and it is usually approached with a conservative medical treatment. Non-Operative Management may be considered also for complicated diverticulitis with abdominal abscess. At present, there is consensus among experts that the hemodynamic response to the initial fluid resuscitation should guide the emergency surgical approach to patients with severe sepsis or septic shock. In hemodynamically stable patients, a laparoscopic approach is the first choice, and surgeons with advanced laparoscopic skills report advantages in terms of lower postoperative complication rates. At the moment, the so-called Hartmann’s procedure is only indicated in severe generalized peritonitis with metabolic derangement or in severely ill patients. Some authors suggested laparoscopic peritoneal lavage as a bridge to surgery or also as a definitive treatment without colonic resection in selected patients. In case of hemodynamic instability not responding to fluid resuscitation, an initial damage control surgery seems to be more attractive than a Hartmann’s procedure, and it is associated with a high rate of primary anastomosis.

HARTMANN'S PROCEDURE FOR CARCINOMA OF THE RECTUM AND SIGMOID COLON

1992 ◽  
Vol 62 (3) ◽  
pp. 200-203 ◽  
Author(s):  
W. J. Adams ◽  
L. J. Mann ◽  
E. L. Bokey ◽  
P. H. Chapuis ◽  
S. G. Koorey ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Hartmann’S Procedure ◽  
Carcinoma Of The Rectum ◽  
Hartmann's Procedure

scholarly journals Colonic invagination anastomosis in surgery of complicated forms of diverticular disease

2021 ◽  
Vol 20 (4) ◽  
pp. 42-48
Author(s):  
Yu. S. Pankratova ◽  
O. Yu. Karpukhin ◽  
M. I. Ziganshin ◽  
A. F. Shakurov
Keyword(s):  
Colorectal Cancer ◽  
Diverticular Disease ◽  
Primary Anastomosis ◽  
Colorectal Anastomosis ◽  
Hartmann’S Procedure ◽  
Control Group ◽  
Stoma Closure ◽  
Double Row ◽  
Hartmann's Procedure ◽  
Anastomosis Leakage

AIM: to evaluate the prospects of using a colorectal invaginated anastomosis in patients with complicated diverticular disease (CDD).PATIENTS AND METHODS: during the period from 2014 to 2020, colorectal invaginated anastomosis, was used in 42 patients: 18 patients with CDD and 20 patients with colorectal cancer for stoma closure after Hartmann’s procedure. The comparison group consisted of 24 patients with CDD and 20 patients with colorectal cancer for stoma closure after Hartmann’s procedure: colorectal anastomosis was created here using traditional double-row handsewn technique. All patients underwent surgery with open access, while the primary anastomosis was performed in 20 (47.6%) patients, and in 22 (52.4%) patients of the group underwent stoma takedown.RESULTS: no anastomosis leakage developed in the main group. Moreover, the presence of single small diverticula with a diameter of 2–3 mm near the area of the anastomosis was not an indication to extend the resection borders. In the control group, in 13 (54.2%) patients, small diverticula were detected in the anastomosis are as well and required to expand the proximal border of resection. In this group, anastomosis leakage occurred in 2 (6.8%) patients with diverticular disease and required Hartmann’s procedure.CONCLUSION: the colorectal invaginated anastomosis is justified for patients with CDD during stoma takedown because it minimizes the risk of anastomosis leakage.

scholarly journals Enough to Bring a Lump to the Throat: Two Emergency Presentations to the Acute Medical Take

2012 ◽  
Vol 11 (3) ◽  
pp. 154-156
Author(s):  
John Northfield ◽  
◽  
Andrew Beale ◽  
Charlotte Cannon ◽  
Laura Gonzalez ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Diverticular Disease ◽  
Hiatus Hernia ◽  
Hartmann’S Procedure ◽  
Sigmoid Perforation ◽  
Hartmann's Procedure ◽  
History Of ◽  
Case Number

Case number 1 An eighty nine year old woman was admitted with a two day history of abdominal pain and vomiting. Two months previously she had undergone a Hartmann’s procedure following a sigmoid perforation secondary to diverticular disease. A hiatus hernia had been noted on a CT undertaken prior to her recent surgery (Figure 1).

Ileosigmoid Knotting: Clinical Profiles and Prognostic Outcomes among Patients in a Rural Medical College: A Retrospective Study

2021 ◽  
Vol 8 (10) ◽  
pp. 37-44
Author(s):  
Dhrubajyoti Maulik ◽  
Debjyoti Mandal
Keyword(s):  
Retrospective Study ◽  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Primary Anastomosis ◽  
Hartmann’S Procedure ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Hartmann's Procedure ◽  
Chi Square Test

Background: Ileosigmoid knotting (ISK) is one of the rare causes of acute intestinal obstruction. It has a rapid course for forming gangrene. In this condition, the ileum and sigmoid colon wrap around each other, causing a knot and strangulation of both structures. ISK is extremely rare in North America most cases are reported in Asia and Africa. This is a surgical emergency and an attempt to relieve the obstruction must be done promptly. The management may range from a resection and anastomosis of the ileum and Sigmoid Colon, ileostomy and Hartmann's procedure depending on patients condition and gangrenous bowel segment. Method: It is a retrospective study. Data collection was done for three years from September 2018 to August 2021 in Bankura Sammilani Medical College and Hospital in the Department of General Surgery. Result: In our study 26 patients (M: F ratio 3:1) was identified with ileosigmoid knotting. The mean age of the patients are 43 years (SD+/- 13) in the study population. It more commonly affects males (76.92%) who are in the fourth decade of life. About fifty percent patients (53.84%) presented with shock (chi square test p value <0.05). The double segment gangrene (69.23%) is the most common presentation than single segment. The most of the patients was operated with ileal and sigmoid colon resection and ileostomy and colostomy. The septicemia (23.07%) is the most common cause of mortality in the study (chi square test p value <0.05). Conclusion: Ileosigmoid knotting is a rare cause of intestinal obstruction and bowel ischemia. So the early diagnosis and prompt surgical intervention in general includes bowel resection with ileostomy and or colostomy and or primary anastomosis. Keywords: Ileosigmoid knotting, volvulus, gangrene, ileostomy, Hartmann’s procedure.

scholarly journals Complicated diverticular disease: the changing paradigm for treatment

2012 ◽  
Vol 39 (4) ◽  
pp. 322-327 ◽  
Author(s):  
Abe Fingerhut ◽  
Nicolas Veyrie
Keyword(s):  
Diverticular Disease ◽  
Bed Rest ◽  
Minimal Invasive ◽  
Primary Resection ◽  
Hartmann’S Procedure ◽  
Hartmann Procedure ◽  
Laparoscopic Lavage ◽  
Hartmann's Procedure ◽  
Therapeutic Algorithms ◽  
Purulent Peritonitis

The term "complicated" diverticulitis is reserved for inflamed diverticular disease complicated by bleeding, abscess, peritonitis, fistula or bowel obstruction. Hemorrhage is best treated by angioembolization (interventional radiology). Treatment of infected diverticulitis has evolved enormously thanks to: 1) laparoscopic colonic resection followed or not (Hartmann's procedure) by restoration of intestinal continuity, 2) simple laparoscopic lavage (for peritonitis +/- resection). Diverticulitis (inflammation) may be treated with antibiotics alone, anti-inflammatory drugs, combined with bed rest and hygienic measures. Diverticular abscesses (Hinchey Grades I, II) may be initially treated by antibiotics alone and/or percutaneous drainage, depending on the size of the abscess. Generalized purulent peritonitis (Hinchey III) may be treated by the classic Hartmann procedure, or exteriorization of the perforation as a stoma, primary resection with or without anastomosis, with or without diversion, and last, simple laparoscopic lavage, usually even without drainage. Feculent peritonitis (Hinchey IV), a traditional indication for Hartmann's procedure, may also benefit from primary resection followed by anastomosis, with or without diversion, and even laparoscopic lavage. Acute obstruction (nearby inflammation, or adhesions, pseudotumoral formation, chronic strictures) and fistula are most often treated by resection, ideally laparoscopic. Minimal invasive therapeutic algorithms that, combined with less strict indications for radical surgery before a definite recurrence pattern is established, has definitely lead to fewer resections and/or stomas, reducing their attendant morbidity and mortality, improved post-interventional quality of life, and less costly therapeutic policies.

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