Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Danish Medical Bulletin |
| Vol/bind | 57 |
| Udgave nummer | 6 |
| Sider (fra-til) | A4149 |
| ISSN | 0907-8916 |
| Status | Udgivet - 2010 |
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Laparoscopic reversal of Hartmann's procedure. / Svenningsen, Peter Olsen; Bulut, Orhan; Jess, Per.
I: Danish Medical Bulletin, Bind 57, Nr. 6, 2010, s. A4149.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Laparoscopic reversal of Hartmann's procedure
AU - Svenningsen, Peter Olsen
AU - Bulut, Orhan
AU - Jess, Per
PY - 2010
Y1 - 2010
N2 - INTRODUCTION: A change in procedure from open to laparoscopic reversal of Hartmann's colostomy was implemented at our department between May 2005 and December 2008. The aim of the study was to investigate if this change was beneficial for the patients. MATERIAL AND METHODS: The medical records of all patients who underwent reversal of a colostomy after a primary Hartmann's procedure during the period May 2005 to December 2008 were reviewed retrospectively in a case-control study. RESULTS: A total of 43 patients were included. Twenty-one had a laparoscopic and 22 an open procedure. The two groups matched with regard to age, sex, American Society of Anestheologists (ASA) score, body mass index and indication for Hartmann's operation. A significantly longer operation time was found for laparoscopic than for open surgery (median 285 versus 158 minutes, p < 0.001), but with less blood loss (median 100 versus 600 ml, p < 0.001), faster return of bowel function (median three versus four days, p < 0.01) and shorter postoperative hospitalization (median four versus six days, p < 0.01). No intraoperative complications occurred. One laparoscopic operation was converted (5%). There was no difference in postoperative complications between the two groups (10 versus 14%), and no anastomotic leaks. The total mortality was 2% as one patient died postoperatively after an open operation. CONCLUSION: It is possible for trained laparoscopic colorectal surgeons to perform laparoscopic reversal of Hartmann's procedure as safely as in open surgery and with a faster recovery, shorter hospital stay and less blood loss despite a longer knife time. It therefore seems reasonable to offer patients a laparoscopic procedure at departments which are skilled in laparoscopic surgery and use it for standard colorectal surgery.
AB - INTRODUCTION: A change in procedure from open to laparoscopic reversal of Hartmann's colostomy was implemented at our department between May 2005 and December 2008. The aim of the study was to investigate if this change was beneficial for the patients. MATERIAL AND METHODS: The medical records of all patients who underwent reversal of a colostomy after a primary Hartmann's procedure during the period May 2005 to December 2008 were reviewed retrospectively in a case-control study. RESULTS: A total of 43 patients were included. Twenty-one had a laparoscopic and 22 an open procedure. The two groups matched with regard to age, sex, American Society of Anestheologists (ASA) score, body mass index and indication for Hartmann's operation. A significantly longer operation time was found for laparoscopic than for open surgery (median 285 versus 158 minutes, p < 0.001), but with less blood loss (median 100 versus 600 ml, p < 0.001), faster return of bowel function (median three versus four days, p < 0.01) and shorter postoperative hospitalization (median four versus six days, p < 0.01). No intraoperative complications occurred. One laparoscopic operation was converted (5%). There was no difference in postoperative complications between the two groups (10 versus 14%), and no anastomotic leaks. The total mortality was 2% as one patient died postoperatively after an open operation. CONCLUSION: It is possible for trained laparoscopic colorectal surgeons to perform laparoscopic reversal of Hartmann's procedure as safely as in open surgery and with a faster recovery, shorter hospital stay and less blood loss despite a longer knife time. It therefore seems reasonable to offer patients a laparoscopic procedure at departments which are skilled in laparoscopic surgery and use it for standard colorectal surgery.
M3 - Journal article
C2 - 20515601
VL - 57
SP - A4149
JO - Danish Medical Journal
JF - Danish Medical Journal
SN - 2245-1919
IS - 6
ER -