Abstract
The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann’s procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann’s procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP). The postoperative length of stay (LOS) in the hospital was 5.6 (3–16 days). The overall and major (grades III to V) postoperative morbidities were 33.3 % (n = 14) and 4.8 % (n = 2), respectively. Our preliminary results showed that using the laparoscopic technology in reversal of Hartmann’s colostomy on the concept of ERP is safe and feasible. Patients with intra- or postoperative complications were found to have statistically significant associations with greater risk of ERP failure.
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Hartmann H (1923) Note sur un procede nouveau d’extirpation des cancers de la partie terminale du colon. Bull Mem Soc Chir Paris 00:1474–1477
Desai DC, Brennan EJ, Reilly JF, Smink RD (1998) Utility of the Hartmann procedure. Am J Surg 175:152–154
Foster ME, Leaper DJ, Williamson RCN (1985) Changing patterns in colostomy closure: the Bristol experience 1975–1982. Br J Surg 72:142–145
Sweeney JL, Hoffmann DC (1987) Restoration of continuity after Hartmann’s procedure for the complications of diverticular disease. Aust N Z J Surg 57:823
Roe AM, Prabhu S, Ali A, Brown C, Brodribb JM (1991) Reversal of Hartmann’s procedure: timing and operative technique. Br J Surg 78:1167–1170
Kehlet H (2005) Fast-track colonic surgery: status and perspectives. Recent Results Cancer Res 165:8–13
Niskanen M (2009) Resource use and postoperative outcome: basic elements in benchmarking. Curr Opin Crit Care 15:359–363
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213
Sinz EH (2007) Anesthesiology national CME program and ASA activities in simulation. Anesthesiol Clin 25(2):209–223
Gatt M, Anderson AD, Reddy BS et al (2005) Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection. Br J Surg 92:1354–1362
Kehlet H, Dahl JB (2003) Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362:1921–1928
Hasukic S, Mesic D, Dizdarevic E, Keser D, Hadziselimovic S, Bazardzanovic M (2002) Pulmonary function after laparoscopic and open cholecystectomy. Surg Endosc 16:163–165
Hendolin HI, Paakonen ME, Alhava EM, Tarvainen R, Kemppinen T, Lahtinen P (2000) Laparoscopic or open cholecystectomy: a prospective randomised trial to compare postoperative pain, pulmonary function, and stress response. Eur J Surg 166:394–399
Mazeh H, Greenstein A, Swedish K (2009) Laparoscopic and open reversal of Hartmann’s procedure—a comparative retrospective analysis. Surg Endosc 23:496–502
Slawik S, Dixon AR (2007) Laparoscopic reversal of Hartmann’s rectosigmoidectomy. Color Dis 10:81–83
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Zhang, L., Zhong, Y., Lin, H. et al. Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann’s Procedure. Indian J Surg 78, 453–457 (2016). https://doi.org/10.1007/s12262-015-1402-9
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DOI: https://doi.org/10.1007/s12262-015-1402-9