Conventional and Laparoscopic Reversal of the Hartmann Procedure: a Review of Literature

Wall, Bryan Joost Marinus van de; Draaisma, Werner A.; Schouten, Esther S.; Broeders, I. A. M. J.; Consten, Esther C. J.

doi:10.1007/s11605-009-1084-3

Cited by 150 publications

(171 citation statements)

References 36 publications

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“…Some other authors used the palmer point as entry technique and it was also considered as a safe way of entry [11]. The adhesions are the main cause of conversion to the open technique during laparoscopic reversal procedure [4,6]. In our case series; the only case of conversion was due to severe adhesions.…”

Section: Operative Datamentioning

confidence: 66%

“…The only indication, as a gold standard for HP, remains the stercoral peritonitis due to a sigmoid perforation [5]. Approximately 44% of patients undergo bowel continuity restoration after HP [6]. As shown by Van de Wall review of the literature Reversal of HP is accompanied by a considerable risk of complications (mean 16.3%, range 3%-50%) and has an overall mortality rate of 1%.…”

Section: Operative Datamentioning

confidence: 99%

“…One of them was the use of laparoscopy and its known advantages on open procedure to re-establish the intestinal continuity have been well demonstrated in the last twenty years [4]. Rapid postoperative recovery, less postoperative pain, earlier Ambulation, earlier restoration of bowel function, a more rapid return to a normal diet, and Reduced morbidity are the major advantages of this technique [6]. However, two main challenges faced by the laparoscopic approach: A safe laparoscopic entry in a previously operated abdomen and the severe intraabdominal adhesions.…”

Section: Operative Datamentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic Reversal of Hartmann Procedure: A Single Surgeon Experience

Aboulkacem¹,

Ghalleb²,

Baccari³

et al. 2017

J Gen Pract

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Section: Operative Datamentioning

confidence: 66%

Section: Operative Datamentioning

confidence: 99%

Section: Operative Datamentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Reversal of Hartmann Procedure: A Single Surgeon Experience

Aboulkacem¹,

Ghalleb²,

Baccari³

et al. 2017

J Gen Pract

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“…The reported stoma reversal rate following HP is high (80%), compared to 45% in a systematic review of case series [49] . The initial laparoscopic approach is likely to facilitate stoma reversal, because of less adhesion formation.…”

Section: Limitationsmentioning

confidence: 82%

Emergency Laparoscopic Sigmoidectomy for Perforated Diverticulitis with Generalised Peritonitis: A Systematic Review

et al. 2015

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Background: Laparoscopic sigmoidectomy for diverticulitis has initially been confined to the elective setting. However, open acute sigmoidectomy for perforated diverticulitis is associated with high morbidity rates that might be reduced after laparoscopic surgery. The aim of this systematic review was to assess the feasibility of emergency laparoscopic sigmoidectomy for perforated diverticulitis. Methods: We performed a systematic search of PubMed, EMBASE and CENTRAL. All studies reporting on patients with perforated diverticulitis (Hinchey III-IV) treated by laparoscopic sigmoidectomy in the acute phase were included, regardless of design. Results: We included 4 case series and one cohort study (total of 104 patients) out of 1,706 references. Hartmann's procedure (HP) was performed in 84 patients and primary anastomosis in 20. The mean operating time varied between 115 and 200 min. The conversion rate varied from 0 to 19%. The mean length of hospital stay ranged between 6 and 16 days. Surgical re-intervention was necessary in 2 patients. In 20 patients operated upon without defunctioning ileostomy, no anastomotic leakage was reported. Three patients died during the postoperative period. Stoma reversal after HP was performed in 60 out of 79 evaluable patients (76%). Conclusions: Acute laparoscopic sigmoidectomy for the treatment of perforated diverticulitis is feasible in selected patients provided they are handled by experienced hands.

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“…In practice, however, the patients have to live longer with the stoma. van de Wall et al [7] provided a systematic overview of 35 studies on HP reversal in 6249 patients. Diverticular disease in 67% and colorectal malignancies in 17% were the main indications for HP.…”

Section: Commentary On Hot Topicsmentioning

confidence: 99%

Primary colon resection or Hartmann's procedure in malignant left-sided large bowel obstruction? The use of stents as a bridge to surgery

Grundmann¹

2013

WJGS

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There is still significant debate regarding the best surgical treatment for malignant left-sided large bowel obstruction. Primary resection and anastomosis offers the advantages of a definite procedure without need for further surgery. Its main disadvantages are related to the increased technical challenge and to the potential higher risk of anastomotic leakage that occurs in the emergency setting. Primary resection with end colostomy (Hartmann's procedure) is considered the safer option. Tan et al compared in a systematic review and meta-analysis the use of self-expanding metallic stents (SEMS) as a bridge to surgery vs emergency surgery in the management of acute malignant left-sided large bowel obstruction. The authors concluded that the technical and clinical success rates for stenting were lower than expected. SEMS was associated with a high incidence of clinical and silent perforation. Stenting instead of loop colostomy can be recommended only if the appropriate expertise is available in the hospital. The goal of stenting, a decrease of the stoma rate, may be advocated only if the complication rates of stenting are lower than those of stoma creation in the emergency situation. Until now, this was not demonstrated in a prospective randomized trial. COMMENTARY ON HOT TOPICSThere is still significant debate regarding the best surgical treatment for malignant left-sided large bowel obstruction. In a multicenter German observation study, out of 15 911 patients with cancer of the left colon a total of 743 patients (4.7%) underwent emergency surgery, performed as a radical resection. In 57.9% (n = 430) a one-stage operation, in 11.7% (n = 87) a primary anastomosis with protective stoma, and in 30.4% (n = 226) Hartmann's procedure (HP) were performed [1] . The morbidity and hospital mortality rates (overall hospital mortality, 7.7%, n = 57) did not differ significantly between the groups. With comparable mortality, HP was recommended for high risk patients in the emergency situation. On the basis of a literature search, Trompetas [2] came to a similar conclusion: primary resection with end colostomy (HP) is considered the safest option in malignant left-sided colonic obstruction. The main advantages are that there is no risk of anastomotic dehiscence and the operation can be performed by less experienced and non-specialist surgeons. The main disadvantages of HP are the need for a second major operation to reverse the colostomy, and the fact that 40%-60% of patients do

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Conventional and Laparoscopic Reversal of the Hartmann Procedure: a Review of Literature

Cited by 150 publications

References 36 publications

Laparoscopic Reversal of Hartmann Procedure: A Single Surgeon Experience

Laparoscopic Reversal of Hartmann Procedure: A Single Surgeon Experience

Emergency Laparoscopic Sigmoidectomy for Perforated Diverticulitis with Generalised Peritonitis: A Systematic Review

Primary colon resection or Hartmann's procedure in malignant left-sided large bowel obstruction? The use of stents as a bridge to surgery

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