hartmann’s procedure
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2022 ◽  
Vol 75 (1) ◽  
pp. 36-43
Author(s):  
Ryo Maemoto ◽  
Shingo Tsujinaka ◽  
Ryotaro Sakio ◽  
Nao Kakizawa ◽  
Rei Takahashi ◽  
...  

2021 ◽  
Vol 20 (4) ◽  
pp. 42-48
Author(s):  
Yu. S. Pankratova ◽  
O. Yu. Karpukhin ◽  
M. I. Ziganshin ◽  
A. F. Shakurov

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.


2021 ◽  
Vol 8 (10) ◽  
pp. 37-44
Author(s):  
Dhrubajyoti Maulik ◽  
Debjyoti Mandal

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.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nicholas Frakas ◽  
Michael Conroy ◽  
Holly Harris ◽  
Ross Kenny ◽  
Mirza Baig

Abstract Introduction Henri Albert Hartmann first described resection of the rectosigmoid colon and exteriorization of the bowel with a colostomy in 1921. As we approach the centenary anniversary of Hartmann’s procedure we feel it is the appropriate time to discuss this significant surgical advancement and its relevance in modern day surgery.    Methods We provide a contemporary overview of the literature, highlighting various aspects of the Hartmann’s procedure applicable to both today’s clinical practice and that of tomorrow. Results Hartmann’s procedure was initially performed for colorectal carcinoma in 1921. One hundred years on, the Hartmann’s procedure remains a safe and effective option in select patients with colorectal cancer and at high risk of anastomotic failure. In recent years, the majority of Hartmann’s procedures have been performed for benign disease and the majority of these cases are in the emergency setting. As hospital admissions with acute diverticulitis continue to rise steeply, the importance of the Hartmann’s procedure in the field of surgery continues. Hartmann’s procedure has adapted as surgery has advanced. Hartmann’s is now performed both laparoscopically and robotically with good postoperative outcomes.   Conclusions In 1921, few would have predicted how modern day medicine and surgery is today. Hartmann’s procedure has survived the surgical test of time, and its key principles remain the same. As we look to the future, it is unlikely that it’s role will be lost to surgical advances, but to alternative management modalities in disease prevention.  


2021 ◽  
Author(s):  
Elin Mariusdottir ◽  
Fredrik Jörgren ◽  
Amelia Mondlane ◽  
Jens Wikström ◽  
Marie-Louise Lydrup ◽  
...  

Abstract Background Results of previous studies regarding pelvic sepsis after Hartmann’s procedure (HP) for rectal cancer have been inconsistent and few studies report the risk factors. This study aimed to investigate the incidence of pelvic sepsis after HP, identify risk factors and describe when as well as how pelvic sepsis was diagnosed and treated. Methods Data were collected from the Swedish Colorectal Cancer Registry on all patients undergoing HP for rectal cancer in the county of Skåne from 2007–2017. Patients diagnosed with pelvic sepsis were compared with patients without pelvic sepsis and risk factors for developing pelvic sepsis were analysed in a multivariable model. Results A total of 252 patients were included in the study, with 149 (59%) males, and a median age of 75 years (range 20–92). Altogether, 27 patients (11%) were diagnosed with pelvic sepsis. Risk factors for developing pelvic sepsis were neoadjuvant radiotherapy (OR 7.96, 95% CI 2.54–35.36) and BMI over 25 kg/m2 (OR 5.26, 95% CI 1.80–19.50). Median time from operation to diagnosis was 21 days (range 5-355) with 11 (40%) patients diagnosed beyond 30 days postoperatively. The majority of cases 19 (70%) were treated conservatively and none needed major surgery. Conclusion Pelvic sepsis occurred in 11% of patients. Neoadjuvant radiotherapy and higher BMI were significant risk factors for developing pelvic sepsis. Forty percent of patients were diagnosed later than 30 days postoperatively and most patients were successfully treated conservatively. Our findings suggest that HP is a valid treatment option for rectal cancer when anastomosis is inappropriate, even in patients receiving neoadjuvant radiotherapy.


Author(s):  
Bruna Zini de Paula Freitas ◽  
Fábio Guilherme Campos ◽  
Danilo Toshio Kanno ◽  
Andress Godoy Delben ◽  
José Aires Pereira ◽  
...  

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