Surgical Access Through the Stoma for Laparoscopic Reversal of Hartmann Procedures

Parkin, Edward T.; Khurshid, Mujahid; Ravi, Srinivasan; Linn, Thu

doi:10.1097/sle.0b013e3182803163

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…Prior peritonitis and resultant adhesions complicate entry into the peritoneal cavity; thus, when using a laparoscopic approach, entry under direct visualization through the Hasson technique is recommended. Entry is gained in the periumbilical location or through the stoma site, 53 but can also be safely achieved in the left upper quadrant, lateral to the rectus sheath. After pneumoperitoneum is established, two additional trocars are placed, adhesions are lysed, and, if not previously done, the splenic flexure is mobilized.…”

Section: Stoma Site Onlymentioning

confidence: 99%

Considerations in Stoma Reversal

Sherman

Wexner

2017

Clinics in Colon and Rectal Surgery

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Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection. Furthermore, many stomas, which were intended to be temporary, may not be reversed due to postoperative complications, adjuvant therapy, or prohibitive comorbidities.

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Section: Stoma Site Onlymentioning

confidence: 99%

Considerations in Stoma Reversal

Sherman

Wexner

2017

Clinics in Colon and Rectal Surgery

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“…A free of disease interval of minimum 12 months is the best timing for colostomy restoration. Our option for all the 83 reversals was laparotomy, the rate of laparoscopic stoma reversal after Hartmann procedure being low in literature, as well 7 .…”

Section: Resultsmentioning

confidence: 99%

Does colostomy restoration increase the risk of developing a subsequent rectal cancer?

Socea¹,

Bratu²,

Diaconu³

et al. 2018

Arch Balk Med Union

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La restauration de la colostomie augmente-t-elle le risque de développer un cancer rectal postérieur? Introduction. Au cours des cinq dernières années (du 1er janvier 2013 au 31 décembre 2017), nous avons observé 7 cas de cancer du rectum, développés chez des patients ayant subi une inversion du stoma il y a deux ans, pour différentes affections. Objectifs. C'était un point de départ pour analyser si la restauration du détournement digestif, bien connu pour améliorer la qualité de vie, augmentait également le risque de malignité. Méthodes. Nous avons étudié tous les patients présentant une inversion de la colostomie hospitalisés à la

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“…A review of the literature shows three studies [32,[34][35][36] on the SIR technique. Table 3 summarizes the results.…”

Section: Appraisal Of the Literaturementioning

confidence: 99%

The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity

Clermonts¹,

Stassen²,

Zimmerman³

2017

Laparoscopic Surgery

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Restoration of bowel continuity after Hartmann's procedure is considered technically challenging and is associated with high morbidity and mortality. This is the main reason why restoration of intestinal continuity is often not attempted. Over the past decade, considerable international experience has gained on this topic with new minimally invasive techniques being developed. This review details the evolution of minimally invasive techniques in restoration of colonic continuity after Hartmann's procedure. A comprehensive search of PubMed and Embase was done. Different restoration modalities were included. Eight studies, from six different countries, in which multiport laparoscopic restoration of continuity was compared to conventional open restoration of bowel continuity, were included. In the total of 254 patients, continuity was restored laparoscopically compared with 255 patients in which continuity was performed in open fashion. Restoration of bowel continuity via trephine access was also reported; three studies including 37 patients were included in this review. Single-port restoration of bowel continuity after Hartmann's procedure is a natural evolution of multiport laparoscopy and trephine access. Six studies reporting on single-port reversal of Hartmann's procedure were included with a total of 75 patients. Single-port access in combination with a transanal approach has also been reported; however, data are extremely limited as there is only one study in the published literature. Success of restoration of bowel continuity with less morbidity and mortality has been demonstrated throughout the evolution of the different surgical techniques. In this review advantages of different approaches for restoration of bowel continuity after Hartmann's procedure are discussed. Furthermore, surgical techniques are described, pictorial guides are added for some techniques, and flowcharts are given for easy use during clinical decision-making.

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Surgical Access Through the Stoma for Laparoscopic Reversal of Hartmann Procedures

Cited by 9 publications

References 17 publications

Considerations in Stoma Reversal

Considerations in Stoma Reversal

Does colostomy restoration increase the risk of developing a subsequent rectal cancer?

The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity

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