Laparoscopic restoration of intestinal continuity after Hartman’s procedure
Objective :the aim of this study was to analyse the faisability and the outcome after laparoscopic reversal after Hartman’s procedure (LRH)
Methods :we retrospectively reviewed the medical reports of patients who underwent LRH between january 2003 and February 2008. Data regarding demographics, surgical details and post-operativ course were reviewed. Specifically age, gender, diagnosis at initial operation,Body Mass Index(BMI), American Society of Anesthesiology (ASA) score, comorbidities, operativ time, conversion, complications, time to normal diet, post-operativ bowel movments and hospital stay were assessed.
Results :24 patients have been identified. Median age was 64 years old (32-81).62,5% had ASA score I or II. The procedure was laparoscopically completed for 21 patients. All conversions happened in the beginning of the procedure because of dense adhesions. . Mean operativ time was 101,4 minutes (60-220) and mid hospital stay was 8,9 days (4-30).The overall morbidity rate was 25% (6 patients). One patient needed two reoperations (intraabdominal bleeding and intraabdominal abcess).No anastomotic leak was recorded.The median time to normal diet was 3,2 days (1-6) and to return to bowel function was 3 days (2-5).
Conclusions : In hands of trained and experienced surgeons, Laparoscopic reversal of HArtman’s procedure is a faisable, safe and allow early return to bowell function and hospital discharge.
Program Number: P120