Abordaje laparoscópico para la reconstrucción de tránsito intestinal post-Hartmann: experiencia de un centro sobre 30 pacientes

Caselli, G; Bambs, Claudia; Pinedo, George; Molina, María Elena; Zúñiga, Álvaro; Bellolio, Felipe

doi:10.1016/j.ciresp.2010.08.002

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…As a result, safe entry into the abdominal cavity as well as extensive laparoscopic adhesiolysis for Hartmann's reversal may be challenging. In this review, many authors, in recent years, have used the umbilical Hasson technique [28, 29, 31–33, 49]. This method allows for exploration of the abdominal cavity, feasibility assessment of the laparoscopic technique, and adhesiolysis with dissection of the colostomy under direct vision.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Reversal of Hartmann’s Procedure: State of the Art 20 Years after the First Reported Case

Toro¹,

Ardiri

Mannino

et al. 2014

Gastroenterology Research and Practice

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Introduction. Aim of the present work is to review the literature to point out the role of laparoscopic reversal of Hartmann procedure. Material and Methods. Number of patients, age, sex, etiology, Hinchey classification, interval between procedure and reversal, position of the first trocars, mean operative time (min), number and causes of conversion, length of stay, mortality, complications, and quality of life were considered. Results. 238 males (52.4%) and 216 females (47.6%) between 38 and 67 years were analyzed. The etiology was diverticulitis in 292 patients (72.1%), carcinoma in 43 patients (10.6%), and other in 70 patients (17.3%). Only 7 articles (22.6%) reported Hinchey classification. The interval between initial procedure and reversal was between 50 and 330 days. The initial trocar was open positioned in 182 patients (43.2%) through umbilical incision, in 177 patients (41.9%) in right upper quadrant, and in 63 patients (14.9%) in colostomy site. The operative time was between 69 and 285 minutes. A total of 83 patients (12.1%) were converted and the causes were reported in 67.4%. The length of stay was between 3 and 12 days. 5 patients (0.7%) died. The complications concern 112 cases (16.4%). Conclusion. The laparoscopic Hartmann's reversal is safer and achieves faster positive results.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Reversal of Hartmann’s Procedure: State of the Art 20 Years after the First Reported Case

Toro¹,

Ardiri

Mannino

et al. 2014

Gastroenterology Research and Practice

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“…La RT es considerada como uno de los procedimientos más difíciles en cirugía colorrectal, en parte por la gran cantidad de adherencias intraabdominales secundarias a la OH, y asociada a tasas elevadas de morbilidad [3][4][5][6] . En las últimas décadas, series nacionales e internacionales han demostrado que el abordaje laparoscópico (AL) para la RT es una alternativa segura comparada al abordaje abierto (AA) en manos experimentadas [7][8][9][10] .…”

Section: Introductionunclassified

Abordaje abierto versus laparoscópico para la reconstitución del tránsito luego de la cirugía de Hartmann: Resultados de una experiencia de 10 años

et al. 2022

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Introducción: El objetivo de este estudio es comparar los resultados perioperatorios del abordaje abierto (AA) con el abordaje laparoscópico (AL) para la RT, y determinar factores de riesgo asociados a morbilidad postoperatoria. Material y métodos:Se estudiaron pacientes consecutivos sometidos a RT entre enero de 2007 y diciembre de 2016 en nuestro centro. Se excluyeron aquellos con grandes hernias incisionales que requirieran reparación abierta simultánea. Se consignaron variables demográficas y perioperatorias, y se compararon ambos grupos. Además, se realizó una regresión logística para la identificación de factores de riesgo asociados a morbilidad postoperatoria en la serie.Resultados:Se realizaron 101 RT en el período. Se excluyeron 14 casos por hernia incisional, por lo que se analizaron 87 casos (46 AA y 41 AL). Diez pacientes en el grupo AL (24,4%) requirieron conversión, principalmente por adherencias. La morbilidad total de la serie fue de 36,8%, siendo mayor en el AA (50% vs. 22%, p=0,007). Hubo 1 caso de filtración anastomótica para cada grupo. La estadía postoperatoria fue de 5 (3-52) días para el AL y 7 (4-36) días para el AA (p<0,001). En la regresión logística, sólo el AA fue un factor de riesgo independientemente asociado a morbilidad postoperatoria (OR 2,89, IC 95% 1,11-7,49).Conclusión:El abordaje laparoscópico se asocia a menor morbilidad y estadía postoperatoria que el abordaje abierto para la reconstitución del tránsito post-Hartmann. En nuestra serie, el abordaje abierto fue el único factor independientemente asociado a morbilidad postoperatoria.

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Laparoscopic reversal of Hartmann procedure: is it safe and feasible?

Lucchetta

Manzini

2016

Updates Surg

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The Hartmann procedure (HP) consists of a sigmoidectomy followed by a terminal colostomy in the left iliac fossa and closure of the rectal stump. Although done as a temporary procedure, up to 74 % of patients will not have stoma reversal with subsequent negative impact on the quality of life. A literature search was performed using MEDLINE (PubMed), The Cochrane Library, and Google Scholar, and the articles from January 2000 until December 2015, edited in English, Italian and French, prospective or retrospective, were analyzed. Outcome variables included number of patients, mean age, sex, etiology of Hartmann's procedure, time interval between initial procedure and reversal procedure (in days), mean operative time (in minutes), number of patients converted to open surgery, causes of conversion, length of hospital stay, mortality, and complication rates. For the purpose of this review, only 21 studies were considered for the final analysis and a total of 681 patients were evaluated. The mean time interval between the initial procedure and the reversal (reported in 18 articles) was 181.6 days (range 95-330 days), while the mean operative time (reported in 20 articles) was 163.2 min (range 62-285). Overall, 80 patients (11.7 %) were converted to open technique. The length of hospitalization was between 3 and 12 days. The mortality rate was reported in 19 articles and was 0.7 % (5 patients). 113 patients (16.6 %) underwent post-operative complications. The HP reversal is a challenging procedure, but it can be safely performed laparoscopically providing various advantages when compared to the open technique and it should be proposed only to a selected group of patients, young and without a severe peritonitis at the first operation.

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Abordaje laparoscópico para la reconstrucción de tránsito intestinal post-Hartmann: experiencia de un centro sobre 30 pacientes

Cited by 3 publications

References 21 publications

Laparoscopic Reversal of Hartmann’s Procedure: State of the Art 20 Years after the First Reported Case

Laparoscopic Reversal of Hartmann’s Procedure: State of the Art 20 Years after the First Reported Case

Abordaje abierto versus laparoscópico para la reconstitución del tránsito luego de la cirugía de Hartmann: Resultados de una experiencia de 10 años

Laparoscopic reversal of Hartmann procedure: is it safe and feasible?

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