BACKGROUND Hartmann procedure is still performed in those cases where colorectal anastomosis might be unsafe. Reversal of Hartmann procedure (HR) is considered a major surgical procedure with an high morbidity (55-60%) and mortality rate (0-4%). In order to decrease these rates, laparoscopic Hartmann reversal procedure was successfully experienced. We report our totally laparoscopic Hartmann's reversal technique. METHODS Between 2004 and 2010 we performed 27 HR with totally laparoscopic approach. The efficacy and safety of this technique were demonstrated evaluating the operative data, the postoperative complications and the outcome of the patients. RESULTS There were no open conversions and major intraoperative complications. Anastomotic leaking occurred in one patient requiring an ileostomy; one patient needed a blood transfusion and one had a nosocomial pneumonia. The mean postoperative hospitalization was 5.7 days. CONCLUSIONS Laparoscopic HR is a feasible and safe procedure and can be considered a valid alternative to open HR.

Total Laparoscopic reversal of Hartmann's procedure / Masoni, Luigi; Mari, Francesco Saverio; Nigri, Giuseppe; Favi, F; Pindozzi, F; Dall’Oglio, A; Pancaldi, A; Brescia, Antonio. - In: THE AMERICAN SURGEON. - ISSN 0003-1348. - STAMPA. - (2013).

Total Laparoscopic reversal of Hartmann's procedure.

MASONI, Luigi;MARI, Francesco Saverio;NIGRI, Giuseppe;BRESCIA, Antonio
2013

Abstract

BACKGROUND Hartmann procedure is still performed in those cases where colorectal anastomosis might be unsafe. Reversal of Hartmann procedure (HR) is considered a major surgical procedure with an high morbidity (55-60%) and mortality rate (0-4%). In order to decrease these rates, laparoscopic Hartmann reversal procedure was successfully experienced. We report our totally laparoscopic Hartmann's reversal technique. METHODS Between 2004 and 2010 we performed 27 HR with totally laparoscopic approach. The efficacy and safety of this technique were demonstrated evaluating the operative data, the postoperative complications and the outcome of the patients. RESULTS There were no open conversions and major intraoperative complications. Anastomotic leaking occurred in one patient requiring an ileostomy; one patient needed a blood transfusion and one had a nosocomial pneumonia. The mean postoperative hospitalization was 5.7 days. CONCLUSIONS Laparoscopic HR is a feasible and safe procedure and can be considered a valid alternative to open HR.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/494833
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