| Autor: |
Trépanier, Jean-Sébastien, Arroyave, María, Bravo, Raquel, Jiménez-Toscano, Marta, DeLacy, Francisco, Fernandez-Hevia, María, Lacy, Antonio, Trépanier, Jean-Sébastien, Arroyave, María Clara, Jiménez-Toscano, Marta, DeLacy, Francisco B, Fernandez-Hevia, María, Lacy, Antonio M |
| Předmět: |
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| Zdroj: |
Surgical Endoscopy & Other Interventional Techniques; Dec2017, Vol. 31 Issue 12, p4981-4987, 7p |
| Abstrakt: |
Introduction: Restoration of intestinal continuity after Hartmann's procedure is a technically difficult surgery associated with significant morbidity and mortality. This study presents the short-term results of a new approach: a transanal Hartmann's colostomy reversal assisted by laparoscopy.Method: This is a retrospective analysis of data collected in one tertiary hospital, from October 2013 to November 2015.Results: During the study period, there were ten cases of transanal Hartmann's reversal. Reasons for Hartmann's procedure were: complicated diverticulitis (4), anastomotic leak (3), and recto-sigmoid cancer (3). Rectal stump length was 10.4 ± 4.5 cm. Reconstruction was achieved in all patients. One low colorectal anastomosis was hand-sewn, the other 9 were stapled. Mean operative time was 204 ± 65 min. Diverting loop ileostomies were created in five patients and all were closed during the following year. One case required hand-assistance but there was no conversion to open surgery. Iatrogenic laparoscopic enterotomies occurred in four patients and all were repaired primarily without consequences. Three patients had a total of four post-operative complications: ileus (2), abdominal abscess and wound infection (1). None required reoperation. Mean length of stay was 7.2 ± 4.3 days. One required readmission.Conclusion: A transanal Hartmann's reversal assisted by laparoscopy is a new approach for a difficult surgery. It has the potential to be an additional tool in the case of hostile pelvises or with a rectal stump difficult to identify. The surgery remains challenging and indications need to be clarified. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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