Complication Rates After Hartmann's Reversal: Open vs. Laparoscopic Approach

Haughn, Christopher; Ju, Brian; Uchal, Miroslav; Arnaud, J. P.; Reed, James F.; Bergamaschi, Roberto

doi:10.1007/s10350-008-9264-x

Cited by 60 publications

(73 citation statements)

References 13 publications

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“…S074 Background: Little is known regarding the predictors of favorable outcomes following re-do Anti-reflux surgery (Re-ARS). The aims of this study were: (1) to analyze the efficacy of Re-ARS in resolving dysphagia; and (2) to identify risk factors for persistent or new-onset dysphagia after Re-ARS.…”

Section: Effects Of Nissen Fundoplication On Ablation Of Barrett's Esmentioning

confidence: 99%

2010 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) National Harbor, Maryland, USA, 14-17 April 2010

2010

Surg Endosc

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school of medicine and Palo Alto VA Health Care System Introduction:The cost of medications in the treatment of hypertension and diabetes in the morbidly obese is a significant healthcare burden. In this study we assessed the impact of gastric bypass surgery on medication costs over the course of a lifetime. Methods:We performed a retrospective chart review of patients who had gastric bypass at the Palo Alto VA Health Care System from 2001 to 2007. Preoperative and postoperative medications to treat hypertension and diabetes were identified. Life expectancy was determined using CDC life expectancy tables and Framingham Heart Study data based on body mass index. Comparisons were made between the projected lifetime costs of diabetic and hypertensive medications with or without bariatric surgery using the Student's paired t-test.Results: Of 106 patients who had gastric bypass, 90 had either hypertension or diabetes. Of these patients, 88 (83%) had hypertension and 60 (57%) had diabetes before surgery. Hypertension resolved in 44% and diabetes in 80% at one year after surgery. The projected average lifetime cost of medications to treat hypertension without and with gastric bypass surgery was $1,038.31 vs. $285.98 (p< 0.0001), respectively. To treat diabetes the difference was $10,504.86 vs. $1,139.46 (p< 0.0001) per person. When the subset of patients whose hypertension and diabetes had completely resolved was excluded, the projected average lifetime cost of hypertensive medications without and with gastric bypass was $1,348.57 vs. $513.69 (p< 0.0006), respectively. The projected average lifetime cost of diabetic medications without and with surgery was $22,427.34 vs. $5,697.31 (p< 0.026) respectively. Conclusion:Gastric bypass surgery results in a significant reduction in the lifetime cost of medications to treat hypertension and diabetes in the morbidly obese. These cost-savings are also significant in the subset of patients without complete resolution of their comorbid conditions after surgery.Objective: High-risk patients are at significant risk for venous thromboembolism (VTE) and may benefit from the addition of retrievable inferior vena cava filters (rIVCF) to chemoprophylaxis. However, the optimal VTE prophylaxis has not been established in morbidly obese patients undergoing bariatric surgery. This observational study examines the use of rIVCFs in combination with chemoprophylaxis for high-risk bariatric surgery patients.Methods: A retrospective review was performed of all high-risk morbidly obese patients who underwent bariatric surgery between February 2007 and July 2009. Patients were considered high-risk for the development of a peri-operative VTE if they had a prior history of VTE, a BMI 55 kg/m2, were severely immobile, or had preexisting hypercoaguable condition. All patients underwent a preoperative venous duplex study. RIVCF placement was performed preoperatively on the day of the bariatric procedure. Standard chemoprophylaxis was initiated preoperatively and continued throughout the hospital stay. C...

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Section: Effects Of Nissen Fundoplication On Ablation Of Barrett's Esmentioning

confidence: 99%

2010 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) National Harbor, Maryland, USA, 14-17 April 2010

2010

Surg Endosc

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“…In der Folgezeit wurde dieses Vorgehen hauptsächlich in der Notfallsituation, sei es im Ileus oder bei einer Dickdarmperforation angewendet [2]. Das zweizeitige Vorgehen mit der konventionellen Wiederanschlussoperation im Intervall war mit einer hohen Morbidität von bis zu 60 %, einer Insuffizienzrate von bis zu 15 % und einer Letalität von bis zu 10 % belastet, sodass bei der Hälfte der Patienten auf eine Rückverlage-rung verzichtet wurde [3][4][5][6]. Das permanente Stoma führt neben den spezifischen Komplikationen wie Prolaps, parastomale Hernie und Problemen der Stomaversorgung zu einer deutlichen Verschlechterung der Lebensqualität [7].…”

Section: Originalarbeit 269unclassified

“…[29]. Im Gegensatz zu Haughn können wir keine Aussage zum Langzeitverlauf machen [4]. Interessanterweise konnte er feststellen, dass offen operierte Patienten innerhalb von 6 Monaten signifikant häufiger (13 % versus 3,3 %) wegen Komplikationen von Seiten der Laparotomie reoperiert werden mussten als nach laparoskopischer Operation [4].…”

Section: Operatives Vorgehenunclassified

Die laparoskopische Wiederanschlussoperation nach Hartmann-Resektion

Böttger

Mohseni²,

Beardi³

et al. 2011

Zentralbl Chir

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In the period from January 2003 to June 2009 923 complex laparoscopic colorectal procedures were performed by one surgeon. Data was assessed prospectively in a database including 152 variables. In 15 patients (10 f, 5 m), with a median age of 61 years (range: 35-83 years), discontinuity resection of the colon was performed including 3 patients with open discontinuity resection of the sigma and 12 patients with laparoscopic Hartmann procedures. In all cases continuity of the colon was recovered laparoscopically. Median operation time was 100 min, conversion to an open procedure was not necessary. No intra-operative complications occurred and only one wound infection (6.6 %) was recorded postoperatively with a median postoperative stay of 8 days. Although the laparoscopic approach to recover continuity of the colon is technically challenging, we conclude that the experienced bowel surgeon is able to perform the laparoscopic approach with a low morbidity and mortality by retaining the well known advantages of laparoscopic colonic surgery.

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“…Beside our own publication with 71 patients [1] there is at least another one from Haughn et al [2] with 61 patients.…”

mentioning

confidence: 93%

Letter in response to: Mazeh H, Greenstein AJ, Swedish K, Nguyen SQ, Lipskar A, Weber KJ, Chin EH, Divino CM (2009) Laparoscopic and open reversal of Hartmann’s procedure—a comparative retrospective analysis (Surg Endosc 23:496–502)

Scheidbach

Lippert

2009

Surg Endosc

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Complication Rates After Hartmann's Reversal: Open vs. Laparoscopic Approach

Cited by 60 publications

References 13 publications

2010 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) National Harbor, Maryland, USA, 14-17 April 2010

2010 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) National Harbor, Maryland, USA, 14-17 April 2010

Die laparoskopische Wiederanschlussoperation nach Hartmann-Resektion

Letter in response to: Mazeh H, Greenstein AJ, Swedish K, Nguyen SQ, Lipskar A, Weber KJ, Chin EH, Divino CM (2009) Laparoscopic and open reversal of Hartmann’s procedure—a comparative retrospective analysis (Surg Endosc 23:496–502)

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