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.

scholarly journals Avoiding or Reversing Hartmann’s Procedure Provides Improved Quality of Life After Perforated Diverticulitis

2010 ◽  
Vol 14 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Jefrey Vermeulen ◽  
Martijn P. Gosselink ◽  
Jan J. V. Busschbach ◽  
Johan F. Lange
Keyword(s):  
Quality Of Life ◽  
Hartmann’S Procedure ◽  
Perforated Diverticulitis ◽  
Hartmann's Procedure

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 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 The role of Hartmann’s procedure in the elective management of rectal cancer: results of a Brazilian cohort study

2021 ◽  
Vol 48 ◽  
Author(s):  
ANDERSON RECH LAZZARON ◽  
INGRID SILVEIRA ◽  
PAULINE SIMAS MACHADO ◽  
DANIEL C DAMIN
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Surgical Complications ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Hartmann’S Procedure ◽  
Septic Complications ◽  
Elective Resection ◽  
Defunctioning Stoma ◽  
Hartmann's Procedure

ABSTRACT Background: although preservation of bowel continuity is a major goal in rectal cancer surgery, a colorectal anastomosis may be considered an unacceptably high-risk procedure, particularly for patients with multiple comorbidities. We aimed to assess rates of surgical complications in rectal cancer patients according to the type of procedure they had undergone. Materials and Methods: this cohort included all rectal cancer patients undergoing elective resection at a referral academic hospital over 16 years. There were three study groups according to the type of performed operation: (1) rectal resection with anastomosis without defunctioning stoma (DS); (2) rectal resection with anastomosis and DS; and (3) Hartmann’s procedure (HP). Postoperative complications and clinical outcomes were assessed. Results: four-hundred and two patients were studied. The 118 patients in group 3 were significantly older (>10 years), had higher Charlson Comorbidity Index scores, and more ASA class ≥3 than patients in the other two groups. Sixty-seven patients (16.7%) had Clavien-Dindo complications grade ≥ III, corresponding to an incidence of 11.8%, 20.9%, and 14.4% in groups 1, 2, and 3, respectively (p=0.10). Twenty-nine patients (7.2%) had major septic complications that required reoperation, with an incidence of 10.8%, 8.2% and 2.5% in groups 1, 2 and 3, respectively (p=0.048). Twenty-one percent of the group 2 patients did not undergo the stoma closure after a 24-month follow-up. Conclusion: HP was associated with a lower incidence of reoperation due to intra-abdominal septic complications. This procedure remains an option for patients in whom serious surgical complications are anticipated.

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 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

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.

Rectal stump mucocele after a Hartmann’s procedure causing mechanical ileus

2021 ◽  
Vol 14 (1) ◽  
pp. e237543
Author(s):  
Gregoire Longchamp ◽  
Nicola Colucci ◽  
Frederic Ris ◽  
Nicolas C Buchs
Keyword(s):  
Emergency Department ◽  
Rectal Stump ◽  
Rapid Recovery ◽  
Hartmann’S Procedure ◽  
Abdominal Ct ◽  
Abdominal Bloating ◽  
Mechanical Ileus ◽  
Severe Constipation ◽  
Hartmann's Procedure

Two years after a Hartmann’s procedure, an 85-year-old woman was admitted at our emergency department with abdominal bloating and severe constipation for 5 days. Abdominal CT showed a large rectal stump mucocele associated with compression of surrounding structures, causing a mechanical ileus and a bilateral pyelocaliceal dilatation. Successful transanal drainage with a rectal catheter allowed rapid recovery.

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