scholarly journals Laparoscopic versus open restoration of the gut continuity after Hartmann’s procedure

2018 ◽  
Vol 5 (8) ◽  
pp. 2708
Author(s):  
Ahmed E. Ahmed ◽  
Wael B. Ahmed ◽  
Alaa A. Redwan
Keyword(s):  
Hospital Stay ◽  
Rectal Stump ◽  
Hartmann’S Procedure ◽  
Wound Complications ◽  
Time Interval ◽  
Sigmoid Colectomy ◽  
Lower Quadrant ◽  
Hartmann's Procedure ◽  
Stump Closure ◽  
Significant Difference

Background: In 1921, Hartmann, a French surgeon described his operation for the resection of left-sided colonic carcinoma. The technique described a sigmoid colectomy without anastomosis; a left lower quadrant end colostomy and the rectal stump closure was performed. The aim of this study was to compare the outcome of the laparoscopic and open restoration of the gut continuity after Hartmann operation as regard operative and post-operative complication.Methods: All patients who underwent restoration of the gut continuity after Hartmann’s procedure either laparoscopic Hartmann’s closure or open Hartmann’s reversal between December 2013 and December 2016 were included.Results: Between December 2013 and December 2016, 32 patients underwent restoration of the gut continuity after Hartmann’s procedure in Sohag university hospitals, Egypt, were enrolled in this study.14 patients had a laparoscopic reversal of Hartmann’s colostomy and 18 had an open reversal of Hartmann’s colostomy. There was no significant difference between both groups as regard age, sex, body mass index, length of remaining rectal stump or time interval between primary operation and Hartmann reversal. The most common indication for Hartmann’s colostomy was obstructed recto sigmoid cancer (13/32). The operative time was significantly shorter in LHR group (107 minutes versus 124 minutes p=0.031), time to pass flatus was significantly earlier in LHR (1.70 days versus 3.33 days p=0.000) , wound complications were significantly lower in LHR (1 case versus 8 cases p= 0.044), LHR had less post-operative pain 24 hours after procedure (VAS was 5.93 versus 8.72 p= 0.000).The length of hospital stay was significantly shorter in the LHR group (6.55 days versus 12.14 days P = 0.038), no significant difference between both group as regard intraoperative complications, leakage, reoperation or postoperative complications. Moreover, no mortality was detected in this study.Conclusions: Laparoscopic reversal of Hartmann’s operation is safe as open surgery, and had less postoperative pain, wound infection and shorter hospital stay. It should be the procedure of choice for reversal of Hartmann’s operation.

Clinical evaluation of two adult oxygenator systems in terms of mortality and major adverse events

Perfusion ◽  
2021 ◽  
pp. 026765912110638
Author(s):  
Hüsnü Kamil Limandal ◽  
Mehmet Ali Kayğın ◽  
Servet Ergün ◽  
Taha Özkara ◽  
Mevriye Serpil Diler ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Artery Bypass ◽  
Length Of Hospital Stay ◽  
Fresh Frozen Plasma ◽  
Wound Complications ◽  
Significant Difference ◽  
Delayed Sternal Closure ◽  
Fresh Frozen ◽  
Major Adverse Events

Purpose The primary aim of this study was to examine the effects of two oxygenator systems on major adverse events and mortality. Methods A total of 181 consecutive patients undergoing coronary artery bypass grafting in our clinic were retrospectively analyzed. The patients were divided into two groups according to the oxygenator used: Group M, in which a Medtronic Affinity (Medtronic Operational Headquarters, Minneapolis, MN, USA) oxygenator was used, and Group S, in which a Sorin Inspire (Sorin Group Italia, Mirandola, Italy) oxygenator was used. Results Group S consisted of 89 patients, whereas Group M included 92 patients. No statistically significant differences were found between the two groups in terms of age ( p = .112), weight ( p = .465), body surface area ( p = .956), or gender ( p = .484). There was no statistically significant difference in hemorrhage on the first or second postoperative day ( p = .318 and p = .455, respectively). No statistically significant differences were observed in terms of red blood cell ( p = .468), fresh frozen plasma ( p = .116), or platelet concentrate transfusion ( p = .212). Infections, wound complications, and delayed sternal closure were significantly more common in Group M ( p = .006, p = .023, and p = .019, respectively). Extracorporeal membrane oxygenators and intra-aortic balloon pumps were required significantly more frequently in Group S ( p = .025 and p = .013, respectively). Major adverse events occurred in 16 (18%) patients in Group S and 14 (15.2%) patients in Group M ( p = .382). Mortality was observed in six (6.7%) patients in Group S and three (3.3%) patients in Group M ( p = .232). No statistically significant difference was found between the two groups in terms of length of hospital stay ( p = .451). Conclusion The clinical outcomes of the two oxygenator systems, including mortality, major adverse events, hemorrhage, erythrocyte and platelet transfusions, and length of hospital stay, were similar.

scholarly journals Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

2021 ◽  
Vol 18 (3) ◽  
pp. 176-179
Author(s):  
Ephraim Bitilinyu-Bangoh ◽  
Fatsani Mwale ◽  
Loveness Ulunji Chawinga ◽  
Gift Mulima
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Kamuzu Central Hospital

Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to  describe the surgical  management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data  extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid  resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in  mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has  significant oedema or is gangrenous.

The Violated Neck: Cervical Node Biopsy Prior to Definitive Treatment

1986 ◽  
Vol 94 (6) ◽  
pp. 605-610 ◽  
Author(s):  
K. Thomas Robbins ◽  
Randolph Cole ◽  
Jeffrey Marvel ◽  
Robert Fields ◽  
Patricia Wolf ◽  
...  
Keyword(s):  
Distant Metastases ◽  
Subsequent Treatment ◽  
Response To Treatment ◽  
Definitive Treatment ◽  
Wound Complications ◽  
Control Group ◽  
Time Interval ◽  
Adequate Treatment ◽  
Node Biopsy ◽  
Significant Difference

The intent of this study was to determine whether open neck biopsy for patients with squamous cell carcinoma metastatic to the neck influenced the biologic course of the disease or the response to treatment. One hundred ninety-two patients, treated over a 10-year period at M.D. Anderson Hospital and Tumor Institute, were reviewed; 102 of the 139 patients, whose primary site of disease was identified prior to definitive treatment, were matched with a control group of 204 patients. The results showed no significant difference in wound complications, neck recurrence, distant metastases, and 5-year survival. Also, time interval from the biopsy to subsequent treatment and the type of node biopsy did not appear to have any significant detrimental effect. On the basis of these findings, we conclude that, although it is important to refrain from proceeding with an open biopsy until a complete head and neck evaluation has been done, violation of the neck does not signify a poorer prognosis—provided adequate treatment is subsequently given.

Management of the leaking rectal stump after Hartmann's procedure

1993 ◽  
Vol 165 (2) ◽  
pp. 285-287 ◽  
Author(s):  
Moshe Schein ◽  
Doron Kopelman ◽  
Samy Nitecki ◽  
Moshe Hashmonai
Keyword(s):  
Rectal Stump ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure

scholarly journals Randomised controlled study of laparoscopic versus open reversal of Hartmann’s procedure

2020 ◽  
Vol 7 (11) ◽  
pp. 3563
Author(s):  
Tarek M. Sehsah ◽  
Osama H. Abd-Raboh ◽  
Taha A. Ismail ◽  
Soliman M. Soliman
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Mean Value ◽  
Hartmann’S Procedure ◽  
Controlled Study ◽  
Hartmann's Procedure ◽  
Operative Complications ◽  
The Difference ◽  
Post Operative Complications

Background: Laparoscopic reversal of Hartmann’s procedure has been increasingly practiced worldwide since the laparoscopic era. However, so far only a few studies have been published regarding the results of this procedure. Aim of this study was to compare laparoscopic reversal of Hartmann’s (LHR) versus open reversal of Hartmann’s (OHR) procedure regarding to operative time, postoperative pain, hospital stay, postoperative complications and cost.Methods: This study was conducted on 40 patients with Hartmann’s colostomy admitted to the general surgery department, Tanta university hospitals, during the period from February 2017 to August 2019.Results: Regarding operative time, it was with a mean value 274.75±80.65 min in the LHR group and 156.75±32.81 min in the OHR group. The difference in time to pass flatus was with a mean value 1.78±0.68 days in the LHR group and 2.49±0.78 days in the OHR group. The difference in the hospital stay was with mean value 6.1±2.47 days in the LHR group and 9.3±2.20 days in the OHR group. Regarding post-operative complications; 6 patients (30%) developed post-operative complications while in the OHR group 10 (50%).Conclusions: In this era of minimal-access surgery and with increasing attention to fast-track protocols, we believe the laparoscopic approach should be the standard technique for patients undergoing reversal of Hartmann’s procedure. However, laparoscopic reversal of Hartmann’s procedure needs a surgical learning curve.

scholarly journals Reversal of Hartmann's Procedure in Patients with Very Short Rectal Stump: A New Technique

2013 ◽  
Vol 47 (3) ◽  
pp. 150-152 ◽  
Author(s):  
Gurpreet Singh
Keyword(s):  
Rectal Stump ◽  
Circular Stapler ◽  
Functional Results ◽  
Complete Recovery ◽  
New Technique ◽  
Hartmann’S Procedure ◽  
Distal Stump ◽  
Colonic Injury ◽  
Hartmann's Procedure ◽  
A New Technique

ABSTRACT Objective Reversal of Hartmann's procedure is a difficult surgical exercise with significant morbidity and mortality. One of the difficulties encountered during surgery is the presence of a very short rectal stump. Materials and methods We present two cases where the patients underwent a Hartmann's procedure for abortion induced colonic injury and a subsequent failed attempt at reversal. The distal stump was mobilized from the sacrum (virgin field). An end to side anastomosis was performed between the distal end of colon and the posterior surface of the rectal stump using an end to end circular stapler. Results The patients had a complete recovery with good functional results. Conclusion This is a novel technique which when applied in such situations will prove technically easy and functionally adequate. How to cite this article Singh G, Gupta V. Reversal of Hartmann's Procedure in Patients with Very Short Rectal Stump: A New Technique. J Postgrad Med Edu Res 2013;47(3):150-152.

scholarly journals Management of rectal stump leak following emergency Hartmann’s procedure

2020 ◽  
Vol 40 (4) ◽  
pp. 386-389
Author(s):  
Sarah Johnston ◽  
Penelope De Lacavalerie
Keyword(s):  
Rectal Stump ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure

The Violated Neck: Cervical Node Biopsy Prior to Definitive Treatment

1986 ◽  
Vol 94 (5) ◽  
pp. 605-610 ◽  
Author(s):  
K. Thomas Robbins ◽  
Randolph Cole ◽  
Jeffrey Marvel ◽  
Robert Fields ◽  
Patricia Wolf ◽  
...  
Keyword(s):  
Distant Metastases ◽  
Subsequent Treatment ◽  
Response To Treatment ◽  
Definitive Treatment ◽  
Wound Complications ◽  
Control Group ◽  
Time Interval ◽  
Adequate Treatment ◽  
Node Biopsy ◽  
Significant Difference

The intent of this study was to determine whether open neck biopsy for patients with squamous cell carcinoma metastatic to the neck influenced the biologic course of the disease or the response to treatment. One hundred ninety-two patients, treated over a 10-year period at M.D. Anderson Hospital and Tumor institute, were reviewed; 102 of the 139 patients, whose primary site of disease was identified prior to definitive treatment, were matched with a control group of 204 patients. The results showed no significant difference in wound complications, neck recurrence, distant metastases, and 5-year survival. Also, time interval from the biopsy to subsequent treatment and the type of node biopsy did not appear to have any significant detrimental effect. On the basis of these findings, we conclude that, although it is important to refrain from proceeding with an open biopsy until a complete head and neck evaluation has been done, violation of the neck does not signify a poorer prognosis—provided adequate treatment is subsequently given.

scholarly journals Colorectal reconstructions following Hartmann’s procedure: challenges and solutions

2020 ◽  
pp. 51-57
Author(s):  
A. N. Igolkin ◽  
V. V. Polovinkin
Keyword(s):  
Colorectal Anastomosis ◽  
Rectal Stump ◽  
Hartmann’S Procedure ◽  
Ability To Work ◽  
Scientific Publications ◽  
Hartmann's Procedure ◽  
Narrow Pelvis ◽  
Operating Methods ◽  
Active Formation

The availability of a stoma after Hartmann’s procedure significantly limits the patient’s ability to work and worsens the quality of his/her life, as it partially isolates him/her from society. Performing plastic colon surgeries is challenging due to the active formation of intestinal adhesions and low rectal stump. At present many different devices, equipment, operating methods, and techniques have been proposed for reconstructive surgery on the colon. However, the issues of access to the surgical area, providing constant visual control, both at the stage of isolation for the short stump of the rectum in the narrow pelvis and in formation process of low colorectal anastomosis, are not covered in the scientific publications.

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