Laparoscopically assisted reversal of Hartmann's procedure

Gorey, T. F.; O'Connell, P. R.; Waldron, David; Kerin, Kevin; Fitzpatrick, John M.

doi:10.1002/bjs.1800800135

Cited by 68 publications

(49 citation statements)

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“…In our series of 28 patients, intra-and postoperative adverse events (3.6% and 10.7%, respectively) compared favourably with that reported in the open surgery (13%-50%) [1][2][3][4][5] and laparoscopic surgery (9%-25%) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] literature for reversal of a Hartmann procedure. No clinical leaks were encountered, and there was no mortality.…”

Section: Discussionsupporting

confidence: 62%

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The largest study was that of Vacher and colleagues 13 and consisted of 38 patients. Their conversion rate was 15.8% (6 of 38), the morbidity rate was 23.5% and the mortality rate was 2.7%.…”

Section: Formation Médicale Continuementioning

confidence: 99%

“…1,2 Few studies have examined the role of laparoscopy in performing colostomy reversal after a Hartmann procedure since it was initially reported in 1993. 6 Small series report conversion rates as high as 25% because of multiple and dense adhesions and difficulty in identifying the rectal stump. 7,8 Hand-assisted techniques have also been described.…”

mentioning

confidence: 99%

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Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach

Huynh

Trottier

Soto

et al. 2011

cjs

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Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach Background: Open restoration of bowel continuity after a Hartmann procedure has been associated with significant morbidity, including anastomotic leak, incisional hernia, wound infections and inability to re-establish intestinal continuity. Few studies have examined the role of laparoscopy in performing a Hartmann reversal. The aim of this study was to review our laparoscopic Hartmann reversal (LHR) experience with an emphasis on intra-and postoperative adverse events. Methods:A prospectively collected laparoscopic colorectal database involving 3 surgeons in 4 academic centres between 1991 and 2008 was reviewed. Factors evaluated were patient demographics, diagnosis, duration of surgery, intra-and postoperative complications, recovery of bowel function and length of stay in hospital.Results: Twenty-eight consecutive patients (13 men, 15 women) with a mean age of 61.1 (standard deviation [SD] 15.3) years and a mean weight of 72.3 (SD 20

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Section: Discussionsupporting

confidence: 62%

Section: Formation Médicale Continuementioning

confidence: 99%

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Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach

Huynh

Trottier

Soto

et al. 2011

cjs

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“…These results suggest that laparoscopy-assisted reanas tomosis after Hartmann's procedure can be successfully done in selected patients [4], The described method seems to facilitate the surgical procedure. The initial dissection of the colostomy with the external approach ( fig.…”

Section: Discussionmentioning

confidence: 73%

“…Delayed anastomosis is a well-established procedure, with approximately 55% of patients undergo ing reversal after Hartmann's operation [1], The reversal procedure is associated with a mortality rate ranging from 0 to 14% for anastomosis-related complications (stric tures or leakages) and up to 75% for other complications [1,2]. Furthermore, a number of patients refuse or are not considered fit, and up to 60% do not undergo reversal [3,4], The reversal procedure might be easier to consider when minimally invasive techniques are available and it might offer certain advantages. We describe a minimally invasive technique for the reversal that was undertaken in 6 patients, three procedures being successfully com pleted.…”

mentioning

confidence: 99%

Laparoscopic Reversal of Hartmann’s Procedure – Surgical Technique

Mutter¹,

Évrard²,

Nord³

et al. 1994

Dig Surg

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A laparoscopically assisted procedure for the reversal of Hartmann’s colostomy was undertaken in 6 patients. The procedure was successfully done in 3 of them. The technique started with an external resection of the colostomy and the mobilization of the left colon, followed by a laparoscopic preparation of the rectal stump and a laparoscopically assisted stapled anastomosis. No morbidity and no mortality were noted, the mean operative time with laparoscopy being comparable to that with the open technique. Laparoscopic reversal of Hartmann’s procedure remains a difficult operation that has to be converted to an open procedure in 50% of the cases. When it can be achieved without conversion, the laparoscopic reversal procedure is safe and effective and can be undertaken in selected patients. Its value has to be confirmed by controlled studies.

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Laparoscopic colorectal surgery: A prospective assessment and current perspective

Cohen

Johansen

et al. 1993

Journal of British Surgery

152

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Between August 1991 and June 1993, 74 laparoscopic and laparoscopically assisted colonic and rectal operations were performed. A variety of procedures were carried out including 32 total abdominal colectomies (group 1), 32 segmental resections (group 2) and ten constructions of a diverting stoma without formal resection (group 3). Indications for surgery were mucosal ulcerative colitis in 20 patients, carcinoma in 12, polyposis in six, Crohn's disease in seven and other conditions in the remaining 29. The 74 comprised 42 male and 32 female patients of mean age 45 (range 12-88) years. The median (range) duration of the procedure was 3.0 (1.0-6.5) h for the entire group, 3.9 (2.5-6.5) h for group 1, 2.9 (1.5-5.5) h for group 2 and 1.8 (1.0-2.5) h for group 3. The median (range) length of ileus was 3.0 (2-7) days overall; respective times for groups 1-3 were 3.5 (2-7), 3.0 (2-7) and 2.0 (1-4) days. The median (range) length of hospitalization was 7.0 (2-40) days, 8.1 (4-19) days in group 1, 7.0 (4-20) days in group 2 and 6.0 (2-40) days in group 3. Ten patients (14 per cent) developed intraoperative and 15 (20 per cent) postoperative complications; there were no deaths. These results failed to confirm any significant advantages of laparoscopic or laparoscopically assisted colorectal surgery. Specifically, neither the operating time, nor length of ileus, nor length of hospitalization was improved over standard procedures. Advances in technology and surgical technique may improve such findings in the future.

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Laparoscopically assisted reversal of Hartmann's procedure

Cited by 68 publications

References 0 publications

Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach

Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach

Laparoscopic Reversal of Hartmann’s Procedure – Surgical Technique

Laparoscopic colorectal surgery: A prospective assessment and current perspective

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