Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann’s Procedure

Abstract

The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann's procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann's procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP). The postoperative length of stay (LOS) in the hospital was 5.6 (3-16 days). The overall and major (grades III to V) postoperative morbidities were 33.3 % ( = 14) and 4.8 % ( = 2), respectively. Our preliminary results showed that using the laparoscopic technology in reversal of Hartmann's colostomy on the concept of ERP is safe and feasible. Patients with intra- or postoperative complications were found to have statistically significant associations with greater risk of ERP failure.

International Variation in Surgical Practices in Units Performing Oesophagectomy for Oesophageal Cancer: A Unit Survey from the Oesophago‐Gastric Anastomosis Audit (OGAA)

“…Furthermore, introduction of the Enhanced Recovery after Surgery (ERAS) pathways have led to improved outcomes and early discharge in patients undergoing major abdominal surgery such as hepatobiliary and colorectal surgery as well as cardiothoracic surgery [31–35]. Within oesophago‐gastric surgery, ERAS protocols have recently gained popularity amongst oesophageal surgeons [15, 36].…”

“…Whilst there is limited evidence of benefit, further large-scale randomised controlled trials are required before wide-scale adoption of this technology in oesophago-gastric cancer [29], as are currently being undertaken in rectal cancer [30]. Furthermore, introduction of the Enhanced Recovery after Surgery (ERAS) pathways have led to improved outcomes and early discharge in patients undergoing major abdominal surgery such as hepatobiliary and colorectal surgery as well as cardiothoracic surgery [31][32][33][34][35]. Within oesophago-gastric surgery, ERAS protocols have recently gained popularity amongst oesophageal surgeons [15,36].…”