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Laparoscopic reversal of Hartmann’s procedure

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Abstract

Reestablishing continuity after a Hartmann’s procedure is considered a major surgical procedure with high morbidity/mortality. The aim of this study was to assess the short-/long-term outcome of laparoscopic restoration of bowel continuity after HP. A prospectively collected database of colorectal laparoscopic procedures (>800) performed between June 2005 and June 2013 was used to identify 20 consecutive patients who had undergone laparoscopic reversal of Hartmann’s procedure (LHR). Median age was 65.4. Ten patients (50 %) had undergone surgery for perforated diverticulitis, 3 (15 %) for cancer, and 7 (35 %) for other reasons (volvulus, posttraumatic perforation, and sigmoid perforation from foreign body). Previous HP had been performed laparoscopically in only 3 patients. Median operative time was 162.5 min. All the procedures were completed laparoscopically. Intraoperative complication rate was nil. Post-operative mortality and morbidity were respectively 0 and 10 % (1 pneumonia, 1 bowel obstruction from post-anastomotic stenosis which required resection and redo of the anastomosis). Median time to first flatus was 3 days, to normal diet 5 days. Median hospital stay was 9 days without readmissions. We followed up the patients for a median of 44 months: when asked, all 20 (100 %) said they would undergo the operation (LHR) again; 3 (15 %) had been re-operated of laparoscopic mesh repair for incisional hernia. When performed by experienced surgeons, LHR is a feasible, safe, reproducible operation, which allows early return of bowel function, early discharge and fast return to work for the patient. It has a low morbidity rate.

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References

  1. Hartmann H (1923) Note sur un procédé nouveau d’extirpation des cancers de la partie du colon. Bull Mem Soc Chir Paris 49:1474–1477

    Google Scholar 

  2. Desai DC, Brennan EJ, Reilly JF et al (1998) Utility of the Hartmann procedure. Am J Surg 175:152–154

    Article  CAS  PubMed  Google Scholar 

  3. Demetriades D, Pezikis A, Melissas J et al (1998) Factors influencing the morbidity of colostomy closure. Am J Surg 155:594–596

    Article  Google Scholar 

  4. Bell C, Asolati M, Hamilton E et al (2005) A comparison of complications associated with colostomy reversal versus ileostomy reversal. Am J Surg 190:717–720

    Article  PubMed  Google Scholar 

  5. Banerjee S, Leather AJ, Rennie JA et al (2005) feasibility and morbidity of reversal of Hartmann’s. Colorectal Dis 7:454–459

    Article  CAS  PubMed  Google Scholar 

  6. Maggard MA, Zingmond D, O’Connell JB et al (2004) What proportion of patients with an ostomy (for diverticulitis) get reversed? Am Surg 70:928–931

    PubMed  Google Scholar 

  7. Roig JV, Cantos M, Balciscueta Z et al (2011) Hartmann’s operation: how often is it reversed and at what cost? A multicentre study. Colorectal Dis 13:396–402

    Article  Google Scholar 

  8. Roque-Castellano C, Marchena-Gomez J, Hemmersbach-Miller M et al (2007) Analysis of the factors related to the decision of restoring intestinal continuity after Hartmann’s procedure. Int J Colorectal Dis 22:1091–1096

    Article  PubMed  Google Scholar 

  9. Anderson CA, Fowler DL, White S et al (1993) Laparoscopic colostomy closure. Surg Laparosc Endosc 3:69–72

    CAS  PubMed  Google Scholar 

  10. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications. A new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg 240:205–212

    Article  PubMed Central  PubMed  Google Scholar 

  11. Faure JP, Doucet C, Essique D et al (2007) Comparison of conventional and laparoscopic Hartmann’s procedure reversal. Surg Laparosc Endosc Percutan Tech 17:495–499

    Article  PubMed  Google Scholar 

  12. Haughn C, Ju B, Uchal M et al (2008) Complication rates after Hartmann’s reversal: open vs. laparoscopic approach. Dis Colon Rectum 51:1232–1236

    Article  PubMed  Google Scholar 

  13. Mazeh H, Greenstein AJ, Swedish K et al (2009) Laparoscopic and open reversal of Hartmann’s procedure, a comparative retrospective analysis. Surg Endosc 23:496–502

    Article  PubMed  Google Scholar 

  14. Cellini C, Deeb AP, Sharma A et al (2013) Association between operative approach and complications in patients undergoing Hartmann’s reversal. Br J Surg 100:1094–1099

    Article  CAS  PubMed  Google Scholar 

  15. Park JM, Chi KC (2012) Laparoscopic reversal of Hartmann’s procedure. J Korean Surg Soc 82:256–260

    Article  PubMed Central  PubMed  Google Scholar 

  16. Khaikin M, Zmora O, Rosin D et al (2006) Laparoscopically assisted reversal of Hartmann’s procedure. Surg Endosc 20:1883–1886

    Article  CAS  PubMed  Google Scholar 

  17. van de Wall BJ, Draaisma WA, Schouten ES et al (2010) Conventional and laparoscopic reversal of the Hartmann procedure: a review of the literature. J Gastrointest Surg 14:743–752

    Article  PubMed Central  PubMed  Google Scholar 

  18. Vacher C, Zaghloul R, Borie F et al (2002) Laparoscopic re-establishment of digestive continuity following Hartmann’s procedure. Retrospective study of the French Society of Endoscopic Surgery. Ann Chir 127:189–192

    Article  CAS  PubMed  Google Scholar 

  19. Rosen M, Cobb WS, Kercher KW et al (2005) Laparoscopic restoration of intestinal continuity after Hartmann’s procedure. Am J Surg 189:670–674

    Article  PubMed  Google Scholar 

  20. Carus T, Bollmann S, Lienhard H (2008) Laparoscopic reversal of Hartmann’s procedure: technique and results. Surg Laparosc Endosc Percutan Tech 18:24–28

    Article  PubMed  Google Scholar 

  21. Slawik S, Dixon AR (2008) Laparoscopic reversal of Hartmann’s rectosigmoidectomy. Colorectal Dis 10:81–83

    CAS  PubMed  Google Scholar 

  22. Chouillard E, Pierard T, Campbell R et al (2009) Laparoscopically assisted Hartmann’s reversal is an efficacious and efficient procedure: a case control study. Minerva Chir 64:1–8

    CAS  PubMed  Google Scholar 

  23. Leroy J, Costantino F, Cahill RA et al (2011) Technical aspects and outcome of a standardized full laparoscopic approach to the reversal of Hartmann’s procedure in a teaching centre. Colorectal Dis 13:1058–1065

    Article  CAS  PubMed  Google Scholar 

  24. Masoni L, Mari FS, Nigri G et al (2013) Total laparoscopic reversal of Hartmann’s procedure. Am Surg 79:67–71

    PubMed  Google Scholar 

  25. Maitra RK, Pinkney TD, Mohiuddin MK et al (2013) Should laparoscopic reversal of Hartmann’s procedure be the first line approach in all patients? Int J Surg 11:971–976

    Article  CAS  PubMed  Google Scholar 

  26. Petersen M, Köckerling F, Lippert H et al (2009) Laparoscopically assisted reversal of Hartmann procedure. Surg Laparosc Endosc Percutan Tech 19:48–51

    Article  PubMed  Google Scholar 

  27. Pearce NW, Scott SD, Karran SJ (1992) Timing and method of reversal of Hartmann’s procedure. Br J Surg 79:839–841

    Article  CAS  PubMed  Google Scholar 

  28. Roe AM, Prabhu S, Ali A et al (1991) Reversal of Hartmann’s procedure: timing and operative technique. Br J Surg 78:1167–1170

    Article  CAS  PubMed  Google Scholar 

  29. Huynh H, Trottier DC, Soto CM et al (2011) Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach. Can J Surg 54:133–137

    Article  PubMed Central  PubMed  Google Scholar 

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Conflict of interest

Drs. Valentino Fiscon, Giuseppe Portale, Antonio Mazzeo, Giovanni Migliorini and Flavio Frigo have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Azienda ULSS 15 ‘Alta Padovana’, Via Casa di Ricovero 40, 35013, Cittadella, Padova, Italy

    Valentino Fiscon, Giuseppe Portale, Antonio Mazzeo, Giovanni Migliorini & Flavio Frigo

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  1. Valentino Fiscon
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  2. Giuseppe Portale
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  3. Antonio Mazzeo
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  4. Giovanni Migliorini
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  5. Flavio Frigo
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Correspondence to Giuseppe Portale.

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Fiscon, V., Portale, G., Mazzeo, A. et al. Laparoscopic reversal of Hartmann’s procedure. Updates Surg 66, 277–281 (2014). https://doi.org/10.1007/s13304-014-0268-x

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  • DOI: https://doi.org/10.1007/s13304-014-0268-x

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