Transanal Hartmann’s colostomy reversal assisted by laparoscopy: outcomes of the first 10 patients

Trépanier, Jean-Sébastien; Arroyave, María Clara; Bravo, Raquel; Jiménez-Toscano, Marta; DeLacy, F. Borja; Fernández-Hevia, María; Lacy, Antonio M.

doi:10.1007/s00464-017-5462-8

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…The residual stump, particularly the stump below the peritoneal reflection, is often covered by the peritoneum or surrounding pelvic organs; as such, it is difficult to identify during HR 11,29,30 . Moreover, the hard dissection of adjacent organs around the stump might lead to insufficient mobilization of the stump.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes between laparoscopic and open Hartmann's reversal: A single‐center retrospective study in Japan

Sato

Imaizumi

Kasajima

et al. 2021

Asian J Endoscop Surgery

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Introduction Laparoscopic Hartmann's reversal (LHR) has recently been reported to be safer and more feasible than open Hartmann's reversal (OHR); however, there is limited data on the outcomes of LHR compared with those of OHR from Asian countries. Therefore, we aimed to clarify the postoperative outcomes of LHR compared with OHR, and additionally compare the patient outcomes post‐LHR according to the previous Hartmann's procedure (HP) approach. Methods Patients who underwent OHR and LHR between January 2006 and September 2020 in a single center in Japan, were retrospectively evaluated. Patient characteristics and perioperative data were collected from the medical and surgical records and assessed. Results Overall, 15 and 19 patients underwent OHR and LHR, respectively, between January 2006 and September 2020. LHR was associated with less blood loss (median: 15 mL vs 185 mL; P < .001) and shorter hospital stays (9 days vs 14 days; P = .023) than OHR. There was no significant difference in postoperative complications between LHR and OHR (26.3% vs 40.0%, P = .475). However, two severe anastomotic complications in LHR were observed in patients with the stump below the peritoneal reflection. No significant difference in outcomes was observed between LHR patients who underwent open and laparoscopic HP. Conclusion LHR resulted in positive outcomes regarding estimated blood loss and postoperative hospitalization, compared with OHR. Although the postoperative complications between LHR and OHR were not significant, patients with the stump below the peritoneal reflection may be at a high risk of anastomotic complications.

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Section: Discussionmentioning

confidence: 99%

Comparison of outcomes between laparoscopic and open Hartmann's reversal: A single‐center retrospective study in Japan

Sato

Imaizumi

Kasajima

et al. 2021

Asian J Endoscop Surgery

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“…19 The technique for combined laparoscopic and transanal Hartmann's reversal has been described 20 and the first outcomes have been published recently. 21 Ten patients were submitted to this procedure: there was no morbidity in 7 patients and only 1 Clavien-Dindo IIIA morbidity due to a parastomal abscess drained percutaneously. The mean length of hospitalization was 7.2 days.…”

Section: Other Indicationsmentioning

confidence: 99%

Future Directions

Soares

Chand

2020

Clinics in Colon and Rectal Surgery

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Transanal total mesorectal excision (taTME) is a novel technique that has evolved over the years to address the challenges of low rectal cancer surgery by applying the principles and benefits of laparoscopic surgery to more historic transanal techniques. It has been popularized through its use in rectal cancer, but the transanal approach is slowly being expanded to tackle different clinical scenarios including benign conditions such as inflammatory bowel disease and endometriosis. For all of these new indications, it is the desire to access and begin the dissection in native tissue beyond the pathology which makes this approach applicable to other diseases where anatomy can be challenging. Training pathways to safely introduce taTME in a standardized manner are being developed and implemented in a bid to ensure adequate training to all the surgeons using this technique and thus minimize complications and patient morbidity. The future directions of this promising technique include the use of image and optical technological enhancement to aid navigation, the use of pneumorectum stabilization, and perhaps the use of fluorescence as a safety improvement. Developments have come also from the field of robotics. After a demonstration of feasibility in cadaver models, a growing experience has been gathered in the robotic approach to taTME, covered in the last part of this chapter.

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“…In all cases, surgery was successfully completed using TaTME and no perioperative complications were recorded. Trépanier et al [35] described their technique and experience with 10 patients who underwent reversal of Hartmann's procedure using combined laparoscopic and TaTME approaches. Indications for Hartmann's procedure were complicated diverticulitis, anastomotic leak, and rectosigmoid cancer.…”

Section: Present and Futurementioning

confidence: 99%

The role of transanal total mesorectal excision in rectal surgery

Yellinek¹,

Wexner²

2018

MIS

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Transanal total mesorectal excision (TaTME) is the newest approach for the resection of rectal cancer, according to the principles of TME. The evolution of TaTME started almost 40 years ago and is a combination of several important developments in both micro-endoscopic surgery and transanal surgery. The preliminary clinical data have revealed acceptable TME quality. Clinical trials to determine the long-term oncological results are still in process. In order to master TaTME, the surgeon should be an expert in laparoscopic rectal surgery as well as transanal microsurgery and follow a stepwise training approach. Robotic TaTME using a single-port robotic system is a promising future development.

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Transanal Hartmann’s colostomy reversal assisted by laparoscopy: outcomes of the first 10 patients

Cited by 14 publications

References 24 publications

Comparison of outcomes between laparoscopic and open Hartmann's reversal: A single‐center retrospective study in Japan

Comparison of outcomes between laparoscopic and open Hartmann's reversal: A single‐center retrospective study in Japan

Future Directions

The role of transanal total mesorectal excision in rectal surgery

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