Laparoscopic-assisted reversal of Hartmann'sprocedure: LTP14


    loading  Checking for direct PDF access through Ovid

Abstract

Aim:To evaluate efficacy of laparoscopic-assisted approach in reversal of Hartmann'sprocedure.Method:Thirty-four patients (18 men, aged 55.7 ± 11.5 years) underwent laparoscopic-assisted reversalprocedures in May 2008-May 2010. Length of rectal stump > 10 cm was the criterion of inclusion. Comparable control group consisted of 33 patients (15 men, aged 51.5 ± 13.9 years).Results:Operation time was 179.5 ± 66.1 min, 266.9 ± 71.8 min in controls (P < 0.0001). Blood loss was 64.7 ± 33.7 ml, 181.8 ± 120.4 ml in controls (P < 0.0001). No conversions occurred in main group. In three patients of main grouppreventive ileostomy was performed. There were 10 diverting stomas in control group (P = 0.03). First defecation was observed in 2.9 ± 0.8 days after surgery (4.1 ± 1.5 days in controls, P < 0.0001). Postoperative hospital stay was 9.1 ± 2.5 days (12.9 ± 3.4 days in controls, P < 0.0001). There were 2 (5.9%) postoperative complications in main group: one wound infections and one parastomal fistula and no mortality occurred. In control group 3 (9.1%) complications (wound infection) were detected (P = 0.61).Conclusion:Laparoscopic-assisted reversal of Hartmann'sprocedurepromotes faster rehabilitation, its results are not worse than after open approach.

    loading  Loading Related Articles