Modified hartmann procedure in emergency sigmoid colectomy

Nakhgevany, Karim B.

doi:10.1016/0002-9610(83)90423-3

Cited by 1 publication

(2 citation statements)

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“…Therefore, several methods to overcome this problem, including fixation of the rectal pouch to presacral fascia, illumination of the rectal lumen, and creating a mucous fistula or leaving long silks on the suture line, were previously suggested. [3][4][5][6] However, none of these suggestions are focused on reducing adhesions but rather on identifying distal rectum, and, moreover, foreign bodies that are left in the pelvis may further exacerbate adhesion formation.…”

Section: Commentsmentioning

confidence: 99%

“…Several tips were suggested to overcome this dilemma. [3][4][5][6] Furthermore, postoperative intraperitoneal adhesions are still an important clinical problem, particularly in the developed countries; thus, many drugs and methods were produced and defined to treat this surgical complication. [7][8][9] A combination of a sodium hyaluronate and carboxymethylcellulose-based antiadhesive membrane (Seprafilm, Adhesion Barrier; Genzyme Corp, Cambridge, Mass) was found to reduce postoperative adhesions by randomized prospective clinical studies.…”

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confidence: 99%

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Seprafilm May Ease Colostomy Reversal

Sarıbeyoğlu

Pekmezci²,

Ulualp³

2004

Arch Surg

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In this study, we aimed to investigate whether the use of a sodium hyaluronate and carboxymethylcellulose-based antiadhesive membrane (Seprafilm, Adhesion Barrier; Genzyme Corp, Cambridge, Mass) is associated with fewer adhesions around the pelvis and rectal pouch. Design, Interventions, and Main Outcome Measures: Forty Wistar albino female rats were divided into 4 equal groups. Each rat underwent segmental left-sided colonic resection and end colostomy. The groups were as follows: group 1, colostomy alone (control group); group 2, colostomy and Seprafilm application around distal rectal pouch; group 3, colostomy and Seprafilm application beneath laparotomy incision; and group 4, colostomy and application of Seprafilm on both rectal pouch and laparotomy incision. All animals were operated on the 21st day and intra-abdominal adhesions were evaluated. Results: The results were assessed by analysis of variance and Tukey multiple comparison tests. Intraabdominal adhesions were significantly (PϽ.05) reduced in groups 2 through 4 compared with the control group, whereas no statistically significant difference was observed between these 3 groups. Conclusions: The use of Seprafilm during the initial step of the Hartmann colostomy reduced intra-abdominal adhesions on the reversal. This result might be beneficial in the prevention of adhesion-related difficulties during second operation and its application beneath laparotomy incision seems to be sufficient to ensure this effect.

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confidence: 99%

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confidence: 99%