Considerations in Stoma Reversal

Sherman, Karen L.; Wexner, Steven D.

doi:10.1055/s-0037-1598157

Cited by 76 publications

(87 citation statements)

References 52 publications

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“…Once the acute medical conditions improves and after the anastomosis has been proven to be healed, the stoma can be reversed. [24] Ileostomy closure (<3 months) is practical and safe. [25] However, in the present study, the median interval between stoma formation and closure was 8.5 months (range: 4–28 months).…”

Section: Discussionmentioning

confidence: 99%

STROBE-anastomotic leakage after pull-through procedure for Hirschsprung disease

et al. 2018

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This study was undertaken to explore the causes, diagnosis, and treatment of anastomotic leakage after pull-through (PT) procedure for Hirschsprung disease (HD).A retrospective analysis of patients with anastomotic leakage after a PT procedure in the General Surgery Department of Beijing Children's Hospital from July 2013 to June 2016 was undertaken. The surgical characteristics, diagnosis, and treatment were retrospectively analyzed.Among the 213 patients who underwent PT procedures, 5 patients had a documented anastomotic leakage. The median age of these 5 patients at the time of the PT procedure was 6.8 years old, and this was higher than those without anastomotic leakage (1.7 years old). In all patients, rectal examination in the lithotomy position revealed an anastomotic dehiscence at the 6 o’clock position. The abdominal ultrasonography demonstrated retrorectal pneumatosis with or without an abscess in 4 patients. All patients were treated with ileostomies and anastomotic resuturing. The median delay to management was 4 days (range: 1–29 days). Four patients (4/5, 80%) were cured, and 1 (delay, 29 days) of these 4 patients developed postoperative ileus. The remaining patient (delay, 9 days) was required to undergo a repeat PT procedure. For the 4 cured patients, the median follow-up time was 20 months (range: 15–37 months), and these patients defecated 3 times daily at most without soiling.Older children with HD might be prone to anastomotic leakage. The findings of the rectal examination and ultrasonography were distinctive and useful for the diagnosis. Early ileostomy and resuturing of the anastomosis could be used to treat anastomotic leakage.

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Section: Discussionmentioning

confidence: 99%

STROBE-anastomotic leakage after pull-through procedure for Hirschsprung disease

et al. 2018

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“…Closure rates are lower than 50% in most published series [ 4 – 10 ]. A large retrospective study showed that better chances of closure were found in nonneoplastic cases, younger age, male gender, and a low Charlson comorbidity index [ 11 – 13 ]. Despite HR still being generally performed by conventional open surgery, in recent years there has been increasing interest in the application of minimally invasive surgery (MIS) to reduce morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study

Panaccio

Grottola

Percario

et al. 2021

Surgery Research and Practice

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Background. Laparoscopic reversal of Hartmann’s procedure (LHR) offers reduced morbidity compared with open Hartmann’s reversal (OHR). The aim of this study is to compare the outcome of laparoscopic versus open Hartmann reversal. Materials and Methods. Thirty-four patients who underwent Hartmann reversal between January 2017 and July 2019 were evaluated. Patients underwent either LHR (n = 17) or OHR (n = 17). Variables such as numbers of patients, patient’s age, sex, body mass index (BMI), comorbidities, ASA (American Society of Anesthesiology) score, indication for previous open sigmoid resection, mean operation time, rate of conversion to open surgery, length of hospital stay, mortality, and morbidity were retrospectively evaluated. Results. The two groups of patients were homogeneous for gender, age, body mass index, cause of primary surgery, time to reversal, and comorbidities. In 97% of the cases, HP was done by open surgery. Our data revealed no difference in mean operation time (LHR: 180.5 ± 35.1 vs. OHR: 225.2 ± 48.4) and morbidity rate, although, in OHR group, there were more severe complications. Less intraoperative blood loss (LHR: 100 ± 40 mL vs. OHR: 450 ± 125 mL; p value <0.001), shorter time to flatus (LHR: 2.4 days vs. OHR: 3.6 days; p value <0.021), and shorter hospitalization (LHR: 4.4 vs. OHR: 11.2 days; p value <0.001) were observed in the LHR group. Mortality rate was null in both groups. Discussion. LHR is feasible and safe even for patients who received a primary open Hartmann’s procedure. We suggest careful patient’s selection allowing LHR procedures to highly skilled laparoscopy surgeons.

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“…When creating a stoma, the surgeon usually selects a stoma that may be technically easier to close. The rate of the inability to close temporary stomata ranges from 6% to 32%, which can be up to 50% after the Hartmann procedure [4] . Santulli enterostomies are superior over other conventional types of stomas in that they can be closed extraperitoneally or even under local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Santulli enterostomy is an advantageous technique in stoma closure

Işık¹

2017

Haydarpasa Numune Med J

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Considerations in Stoma Reversal

Cited by 76 publications

References 52 publications

STROBE-anastomotic leakage after pull-through procedure for Hirschsprung disease

STROBE-anastomotic leakage after pull-through procedure for Hirschsprung disease

Laparoscopic Versus Open Hartmann Reversal: A Case-Control Study

Santulli enterostomy is an advantageous technique in stoma closure

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