Laparoscopic and open reversal of Hartmann’s procedure—a comparative retrospective analysis

Mazeh, Haggi; Greenstein, Alexander J.; Swedish, Kristin A.; Nguyen, Scott Q.; Lipskar, Aaron M.; Weber, Kaare J.; Chin, Edward; Divino, Celia M.

doi:10.1007/s00464-008-0052-4

Cited by 78 publications

(106 citation statements)

References 25 publications

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“…Additionally, laparoscopic stoma reversal may help decrease the incidence of SSI. 19 Interval hernia repair as opposed to concomitant incisional hernia repair with stoma takedown may be warranted. Our data demonstrated no effect on SSI with skin closure; however, other studies 4 have suggested that the technique used to close incisions may affect the incidence of SSI.…”

Section: Commentmentioning

confidence: 99%

Outcomes and Predictors of Incisional Surgical Site Infection in Stoma Reversal

Liang¹,

Li²,

Avellaneda³

et al. 2013

JAMA Surg

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Importance: Surgical site infection following stoma reversal (SR) poses a substantial burden to the patient and health care system. Its overall incidence is likely underreported and poorly characterized. Improving our understanding of surgical site infection following stoma reversal may help us identify methods to decrease this complication.Objective: To evaluate the incidence of surgical site infection (SSI) and identify predictors of SSI following SR. Setting: An integrated medical system at the Michael E. DeBakey Veterans Affairs Medical Center. Participants and Intervention:All adults undergoing SR during the study period. Main Outcome Measures:Rates of SSI and characteristics of patients with and without SSI were compared. A logistic regression model was developed to identify predictors of SSI.Results: One hundred twenty-eight patients underwent SR; 46 patients (36.0%) had an SSI. In comparison with no SSI, the infection was associated with seromas (17.4% vs 2.4%, P=.004), fascial dehiscence (15.2% vs 2.4%, P =.01), intensive care unit admission (34.8% vs 17.1%, P=.03), increased hospital length of stay (20 vs 9 days, P =.02), readmission (32.6% vs 13.4%, P=.01), delayed wound healing (91 vs 66 days, P=.02), and reoperation (32.6% vs 13.4%, P=.01). On multivariate analysis, history of fascial dehiscence (odds ratio, 16.9; 95% CI, 1.94-387), colostomy (5.07; 2.12-13.0), thicker subcutaneous fat (2.02; 1.33-3.21), and black race (0.35; 0.13-0.86) were associated with incisional SSI. There was no significant difference in patient satisfaction or functional status in late follow-up (1-73 months). Conclusions and Relevance:Surgical site infection is common following SR and is associated with significant morbidity. Four factors are strongly associated with increased risk of SSI in SR: history of fascial dehiscence, thicker subcutaneous fat, colostomy, and white race. Patients with none of these risk factors had a 0% SSI risk; patients with all 4 risk factors had a 100% risk of SSI.

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Section: Commentmentioning

confidence: 99%

Outcomes and Predictors of Incisional Surgical Site Infection in Stoma Reversal

Liang¹,

Li²,

Avellaneda³

et al. 2013

JAMA Surg

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“…Many authors report less intraoperative blood loss, shorter hospital stay, less wound infection rate, less postoperative pain [13,14]. The patient's convalescence, the first ambulation, and oral feeding are achieved faster [15].…”

Section: Operative Datamentioning

confidence: 99%

“…Laparoscopic reversal has shown less morbidity and mortality in relation to open Hartmann's reversal procedure. The morbidity with open Hartmann's reversal is reported at 4%-43% [13], and the mortality rate ranges from 4%-10% [15]. In Toro et al review, morbidity was 15.8% and the mortality was 0.7% [12].…”

Section: Operative Datamentioning

confidence: 99%

Laparoscopic Reversal of Hartmann Procedure: A Single Surgeon Experience

Aboulkacem¹,

Ghalleb²,

Baccari³

et al. 2017

J Gen Pract

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“…Использовали мето-дику введения первого порта справа в подвздошной или мезогастральной области, эндоскопического рассечения спаек в брюшной полости, мобилизации анастомозируемых сегментов толстой кишки. Лик-видацию стомы и наложение анастомоза выполняли последним этапом [11].…”

Section: материал и методыunclassified