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.

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

A new technique for intestinal isoperistaltic anastomosis utilizing a linear stapler for enlargement after anastomosis performed with a circular stapler

2007 ◽  
Vol 21 (10) ◽  
pp. 1891-1894
Author(s):  
H. Takeyama ◽  
H. Sawai ◽  
M. Sato ◽  
Y. Akamo ◽  
M. Yamamoto ◽  
...  
Keyword(s):  
Circular Stapler ◽  
New Technique ◽  
Linear Stapler ◽  
A New Technique

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 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 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.

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.

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