scholarly journals Laparoscopic-assisted reversal of Hartmann's procedure

2010 ◽  
Vol 57 (3) ◽  
pp. 59-65 ◽  
Author(s):  
S. Achkasov ◽  
G. Vorobiev ◽  
A. Zhuchenko ◽  
M. Rinchinov
Keyword(s):  
Wound Infection ◽  
Operation Time ◽  
Main Group ◽  
Hartmann’S Procedure ◽  
Control Group ◽  
Open Approach ◽  
Hartmann's Procedure ◽  
Comparable Control ◽  
Hospital Stays ◽  
Laparoscopic Assisted

BACKGROUND: Postoperative morbidity after reversal of Hartmann's procedure remains high. AIM: to evaluate efficacy of laparoscopic-assisted approach. PATIENTS AND METHODS: 36 patients (19 men, aged 55.71+1.5 years) underwent laparoscopic-assisted reversal procedures in May 2008 - June 2010. The comparable control group consisted of 35 patients (16 men, aged 51.5+13.9 years). RESULTS: operation time was 179.5+65.1 min, 266.9+71.8 min in controls. Blood loss was 64.7+33.7 ml, 181.8+120.4 ml in controls. No conversions occurred in the main group. In three patients of the main group preventive ileostomy was performed. There were 11 diverting stomas in the control group. Postoperative hospital stays were 9.1+2.7 days (12.9+3.4 days in controls). There were 2 (5.9%) postoperative complications in the main group: one wound infection and one parastomal fistula. No mortality occurred. In the control group 3 (9.1%) complications (wound infection and haematoma) were detected. CONCLUSION: laparoscopic-assisted reversal of Hartmann's procedure promotes faster rehabilitation, its results are not worse than after open approach.

scholarly journals Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Paolo Panaccio ◽  
Tommaso Grottola ◽  
Rossana Percario ◽  
Federico Selvaggi ◽  
Severino Cericola ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Open Surgery ◽  
Operation Time ◽  
Hartmann’S Procedure ◽  
Morbidity Rate ◽  
Mortality And Morbidity ◽  
Conversion To Open Surgery ◽  
Hartmann's Procedure ◽  
Hartmann Reversal

Background. Laparoscopic reversal of Hartmann’s procedure (LHR) offers reduced morbidity compared with open Hartmann’s reversal (OHR). The aim of this study is to compare the outcome of laparoscopic versus open Hartmann reversal. Materials and Methods. Thirty-four patients who underwent Hartmann reversal between January 2017 and July 2019 were evaluated. Patients underwent either LHR (n = 17) or OHR (n = 17). Variables such as numbers of patients, patient’s age, sex, body mass index (BMI), comorbidities, ASA (American Society of Anesthesiology) score, indication for previous open sigmoid resection, mean operation time, rate of conversion to open surgery, length of hospital stay, mortality, and morbidity were retrospectively evaluated. Results. The two groups of patients were homogeneous for gender, age, body mass index, cause of primary surgery, time to reversal, and comorbidities. In 97% of the cases, HP was done by open surgery. Our data revealed no difference in mean operation time (LHR: 180.5 ± 35.1 vs. OHR: 225.2 ± 48.4) and morbidity rate, although, in OHR group, there were more severe complications. Less intraoperative blood loss (LHR: 100 ± 40 mL vs. OHR: 450 ± 125 mL; p value <0.001), shorter time to flatus (LHR: 2.4 days vs. OHR: 3.6 days; p value <0.021), and shorter hospitalization (LHR: 4.4 vs. OHR: 11.2 days; p value <0.001) were observed in the LHR group. Mortality rate was null in both groups. Discussion. LHR is feasible and safe even for patients who received a primary open Hartmann’s procedure. We suggest careful patient’s selection allowing LHR procedures to highly skilled laparoscopy surgeons.

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.

Uterine fibroids, laparoscopic surgery and morcellation: comparative analysis of the results of organ-preserving operations

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 73-77
Author(s):  
Alexander A. Seregin ◽  
Anastasiia B. Nadezhdenskaia ◽  
Anna S. Makarova ◽  
Polina L. Sheshko ◽  
Anna V. Tregubova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Blood Loss ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Operation Time ◽  
Main Group ◽  
Laparoscopic Myomectomy ◽  
Control Group ◽  
Tumor Spread ◽  
Plastic Containers

Aim. To conduct a comparative analysis of the results of organ-preserving laparoscopic operations performed for uterine fibroids with the use of plastic containers for morcellation and without it. Materials and methods. We examined 57 patients with a diagnosis of uterine fibroids who were admitted to the Department of Innovative Oncology and Gynecology of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology for organ-preserving surgical treatment. To achieve the goal of the study, the patients were divided into the following groups: the main group 29 patients who underwent laparoscopic myomectomy and morcellation of removed nodes using plastic containers. The control group consisted of 28 patients who underwent morcellation during laparoscopic myomectomy without the use of plastic containers. Results. The duration of laparoscopic operations performed using plastic containers main group was 85.6925.87 minutes. Laparoscopic conservative myomectomies, performed without the use of limiting systems, took a slightly longer amount of time control group 88.7530.36 minutes. There were no statistically significant differences, but in the second group, more prolonged sanitation of the abdominal cavity and removal of small fragments of myomatous nodes after morcellation outside the sacs were required. Autoinfusion was used in 6 (20.69%) patients in the main group, in 7 (25%) patients in the control group. Blood transfusion was not used in any case. Average blood loss was 120.6967.50 ml in the main group, 125.0099.54 ml in the control. The duration of hospitalization in the main group was 4.661.76 days, in the control group 5.793.62 days. In the main group, histological examination revealed leiomyoma in all cases, leiomyoma was detected in 96.4% (27 patients) of cases in the control group, and leiomyosarcoma in 1 patient (3.6%). Conclusion. In all groups of patients, there was a favorable course of the postoperative period, early activation of patients. In the group of laparoscopic operations, one patient (3.6%) after morcellation of the myomatous node without the use of a plastic container was found to have leiomyosarcoma. The use of plastic containers in our study did not increase the duration of operations and did not affect the volume of blood loss, the frequency of intra- and postoperative complications. In contrast, the operation time was slightly higher among patients who were operated without the use of containers. In all likelihood, this was due to the fact that the morcellation stage itself took longer, since it was required to extract small fragments of myomatous nodes, as well as thorough and prolonged sanitation of the abdominal cavity. It should be noted that the use of plastic containers, of course, requires the development of certain skills from the surgeon, taking less and less time in parallel with the learning curve. Of course, further studies are required to assess the risk of tumor spread in patients undergoing surgery using plastic containers, but preliminary data indicate that ablastic morcellation can and should be used in organ-preserving surgery for uterine myoma.

scholarly journals Single-port Laparoscopic Reversal of Hartmann's Procedure: Technique and Results

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Th. Carus ◽  
A. Emmert
Keyword(s):  
Laparoscopic Surgery ◽  
Single Port ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Hartmann’S Procedure ◽  
Laparoscopic Technique ◽  
High Morbidity ◽  
Conventional Laparoscopic ◽  
Hartmann's Procedure ◽  
Port Access

In general, reversal of Hartmann's procedure is associated with a high morbidity and therefore leads to a low rate of intestinal restoration. Reversal of Hartmann's procedure has to be seen as a complex abdominal operation with the same possible complications as in other colorectal resections. By using the laparoscopic technique, operative access trauma by laparotomy can be minimized. After introducing single-port access into laparoscopic surgery beginning with cholecystectomies and sigmoid resections, we started with the first single-port laparoscopic reversal of Hartmann's procedure in January 2010. After excision of the colostoma, mobilization, and reponing into the abdominal cavity, the single-port trocar was placed at the stoma incision without any extra scar. We investigated whether the single-port laparoscopic reversal is as safely feasible as the “conventional” laparoscopic procedure. Till December 2010, single-port reversal operation was performed in 8 patients 2–4 months after Hartmann's procedure because of complicated diverticulitis. No conversion to “conventional” laparoscopic or open procedure was necessary in 1 patient one extra 5 mm trocar was used. The average operation time was 74 min. Except for one wound complication, the postoperative course was uncomplicated. The patients were discharged after 4 to 8 postoperative days. Single-port reversal of Hartmann's procedure has showed as a new method for minimizing the access trauma even further than “conventional” laparoscopic surgery.

scholarly journals Laparoskopinis žarnos vientisumo atkūrimas po Hartmanno operacijos

2012 ◽  
Vol 10 (1-2) ◽  
pp. 0-0
Author(s):  
Algimantas Stašinskas ◽  
Juozas Stanaitis
Keyword(s):  
Blood Loss ◽  
Open Surgery ◽  
Intraoperative Complications ◽  
Total Mortality ◽  
Operation Time ◽  
Bowel Function ◽  
University Hospital ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Study Results

Center of General Surgery, Faculty of Medicine, Republican Vilnius University Hospital, Šiltnamių Str. 29, Vilnius, Lithuania E-mail: [email protected]; [email protected], [email protected] Introduction A change in procedure from open to laparoscopic reversal of Hartmann’s colostomy was implemented at our department between May 2009 and December 2010. The aim of the study was to investigate whether this change was beneficial for the patients. Methods The medical records of all patients who underwent colostomy reversal after a primary Hartmann’s procedure during the period from May 2009 to December 2010 were reviewed retrospectively in a case control study. Results A total of 13 patients were included. Six had a laparoscopic and 7 an open procedure. The two groups matched with regard to age, sex, the American Society of Anaesthestist (ASA) score, body mass index and indication for Hartmann’s operation. A significantly longer operation time was found for laparoscopic than for open surgery (median 285 versus 158 minutes,p < 0.001), but with a less blood loss (median 100 versus 600 ml, p < 0.001), faster return of bowel function (median three versus four days, p < 0.01) and a shorter postoperative hospitalization (median four versus six days, p < 0.01). No intraoperative complications occurred. One laparoscopic operation was converted (16.6%). There was no difference in postoperative complications between the two groups (10 versus 14%) and no anastomotic leaks. The total mortality was 0. Conclusion It is possible for trained laparoscopic general surgeons to perform laparoscopic reversal of Hartmann’s procedure as safely as in open surgery and with a faster recovery, shorter hospital stay and less blood loss despite a longer knife time. Therefore, it seems reasonable to offer patients a laparoscopic procedure at departments skilled in laparoscopic surgery and use it for standard colorectal surgery. Key words: laparoscopic reversal of Hartmann’s colostomy; restoration of intestinal continuity

Laparoscopic assisted pancreaticoduodenectomy vs. totally laparoscopic pancreaticoduodenectomy for malignant tumor: a retrospectively controlled study

2020 ◽  
Author(s):  
Guo-Liang Yao ◽  
Jing-Ming Zhai
Keyword(s):  
Malignant Tumor ◽  
Statistical Difference ◽  
Operation Time ◽  
Visual Analogue Score ◽  
Controlled Study ◽  
Open Approach ◽  
Laparoscopic Pancreaticoduodenectomy ◽  
Biliary Leakage ◽  
Laparoscopic Assisted ◽  
Totally Laparoscopic

Abstract Background Laparoscopic pancreaticoduodenectomy was now accepted worldwide with potential advantages over open pacreaticoduodenectomy. The defect was time wasting with the prone of increased postoperative complications. To assess the potential superiority and feasibility of laparoscopic assisted pancreaticoduodenectomy (LAPD) comparing to totally laparoscopic pancreaticoduodenectomy (TLPD), we introduce this study.Methods Retrospectively analyzed the relation data from the patients who had laparoscopic pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital of Henan University of Science and Technology during January 2015 to July 2019. Complications and operation time were compared. SPSS 16.0 was employed for analysis.Results Both groups had almost the same baseline characteristics, such as Sex (P=0.880), Age (P=0.861), ASA (P=0.559), BMI (P=0.854), pancreatic duct size (P=0.623), pancreatic texture (P=0.573) and tumor origin (P=0.878). LAPD was association to shorter operation time (231.6±43.7 min VS. 305.4±55.3 min; P=0.047), pancreaticojejunostomy time (13.8±4.2 min VS. 41.6±9.4 min; P=0.007), gastrojejunostomy time (10.9±3.0 min VS. 24.8±6.5 min; P=0.014) and jejunojejunostomy time (7.8±2.4 min VS. 23.4±5.8 min; P=0.005). No statistical difference was observed relation to resection time (P=0.864), cholangiojejunostomy time (P=0.897), blood loss (P=0.723), number of required transfusion (P=0.809), and incision length (P=0.183). Both groups had comparable conversion to open approach (P=0.402). LAPD had comparable complications to TLPD, such as pancreatic leakage (P=0.328), biliary leakage (P=0.673), bleeding (P=0.889), pneumonia (P=0.809) and thrombosis (P=0.443) and incision infection (P=0.889). No statistical difference was observed relation to visual analogue score at 1 day postoperatively (P=0.913) and hospitalization (P=0.137).Conclusions Laparoscopic assisted pancreaticoduodenectomy with open pancreaticojejunostomy should be a choice for certain surgeons with less operation time.

scholarly journals SHORT-TERM OUTCOMES OF LAPAROSCOPIC ELECTIVE COLONIC RESECTIONS FOR DIVERTICULAR DISEASE

2019 ◽  
Vol 18 (2) ◽  
pp. 55-68
Author(s):  
D. K. Puchkov ◽  
D. A. Khubezov ◽  
K. V. Puchkov ◽  
E. I. Semionkin ◽  
A. Y. Ogoreltsev ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Postoperative Period ◽  
Abdominal Mass ◽  
Randomized Study ◽  
Colorectal Anastomosis ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Main Group ◽  
Control Group ◽  
Elective Colon

AIM: to assess the feasibility and safety of laparoscopic elective colon resections for diverticular disease.PATIENTS AND METHODS: a retrospective non-randomized study included 38 patients with elective colon resection for diverticular disease. Twentysix underwent laparoscopic resections (main group), 12 – open resections (controls). The indications for surgery were: chronic diverticulitis, pericolic abdominal mass, external and internal colon fistulas and stricture of the colon. RESULTS: operation time was the same in the control group (167.1±73.3 vs 129.9±43.7 min,p=0.06). Thirty-three (86.8%) resections were performed with a colorectal anastomosis and 5 (13.2%) obstructive resections of the sigmoid colon. In the main group, the inferior mesenteric artery (IMA) was divided at the origin in 4 (15.4%) cases, in the control group – in 6 (50%) (p=0.045). The anastomotic leakage in the main group was in 3 (11.5%) patients, in the control group – in 1 (8.3%)(p=1.0). The postoperative period was significantly shorter in the main group compared with the controls(9.3±2.8 vs 13.4±5.1 days, p=0.003). After laparoscopic procedures, narcotic analgesics were used in 3 (11.5%) cases, after conventional – in 8 (66.7%) (p=0.001).CONCLUSION: laparoscopic approach is comparable to the conventional onein operative timeand postoperative morbidity. Laparoscopic approach is associated with a significantly less postoperative pain syndrome and a shorter postoperative period, more often allows to preserve the IMA as well.

scholarly journals Total Mesorectal Excision for Mid-Rectal Cancer Without Anastomosis: Low Hartmann’s Operation or Intersphincteric Abdomino-Perineal Excision?

2018 ◽  
Vol 108 (3) ◽  
pp. 233-240
Author(s):  
M. Popiolek ◽  
K. Dehlaghi ◽  
S. Gadan ◽  
B. Baban ◽  
P. Matthiessen
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Colorectal Anastomosis ◽  
Operation Time ◽  
Perineal Wound ◽  
Pelvic Abscess ◽  
Hartmann’S Procedure ◽  
Mesorectal Excision ◽  
Hartmann's Procedure ◽  
Tumor Level

Background and Aims: In mid-rectal cancer, the low colorectal anastomosis is, although feasible, sometimes avoided. The aim was to compare low Hartmann’s procedure with intersphincteric abdomino-perineal excision of the rectum, in patients operated with total mesorectal excision for mid-rectal cancer in whom the low anastomosis was technically feasible but for patient-related reasons undesired. Material and Methods: A total of 64 consecutive patients with mid-rectal cancer who underwent low Hartmann’s procedure (n = 34) or intersphincteric abdomino-perineal excision (n = 30) at one colorectal unit were compared regarding patient demography, short-term oncology, surgical outcome at 3 and 24 months, and long-term overall survival. Results: There were no significant differences between intersphincteric abdomino-perineal excision and Hartmann’s procedure regarding age, gender distribution, body mass index, preoperative radiotherapy, tumor level, or cancer stages. Operation time was shorter in Hartmann’s procedure as compared with intersphincteric abdomino-perineal excision, median 174 and 256 min, (P < 0.001), and intraoperative blood loss was increased, 600 and 500 mL, respectively (P = 0.045). Number of lymph nodes and circumferential resection margin were comparable. In Hartmann’s procedure compared with intersphincteric abdomino-perineal excision, the need for reoperation was 24% and 3%, (P = 0.020), complications classified as Clavien–Dindo 3–4 occurred in 32% and 10%, (P = 0.031), pelvic abscess in 21% and 10%, (P = 0.313), and mortality within 90 days was 3% and 0%, respectively, (P = 0.938). In intersphincteric abdomino-perineal excision, the perineal wound was not healed at 3 months in 13%, and in Hartmann’s procedure 15% had chronic secretion from the anorectal remnant at 2 years postoperatively. Conclusion: The results from this study suggest that intersphincteric abdomino-perineal excision might be an alternative to Hartmann’s procedure in patients with mid-rectal cancer, in whom a low colorectal anastomosis is undesired.

scholarly journals LAPAROSCOPIC-ASSISTED HARTMANN'S PROCEDURE FOR COLORECTAL CANCER-INSTITUTIONAL EXPERIENCE WITH THREE CASES

2009 ◽  
Vol 70 (8) ◽  
pp. 2281-2285
Author(s):  
Jo TASHIRO ◽  
Shigeki YAMAGUCHI ◽  
Tomonori HOSONUMA ◽  
Toshimasa ISHII ◽  
Takahiro SATO ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Institutional Experience ◽  
Laparoscopic Assisted
Sign in / Sign up

Export Citation Format

Share Document