Faure Jean Pierre, Doucet Carole, Essique David, Badra Youssef, Carretier Michel, Richer Jean Pierre, Scépi Michel
Service Chirurgie Viscérale Digestive et Endocrinienne, Centre de Don de Corps, Faculté de Médecine et de Pharmacie, Université de Poitiers, 6 rue de la Miletrie, BP 199, 86034 Poitiers cedex, France.
Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):495-9. doi: 10.1097/SLE.0b013e3180f61762.
This study compares open Hartmann's procedure reversal (OHPR) and laparoscopic Hartmann's procedure reversal (LHPR) in patients first treated for peritonitis (Henchey III or IV).
Fourteen patients who underwent LHPR during a 2-year period were compared with 20 patients who had previously undergone an open procedure at the same institution.
Conversion rate was 14.28%. Operating time was shorter for the laparoscopic group [143 (90 to 240) vs. 180 (90 to 350) min, P<0.05]. Hospital length of stay was shorter for the laparoscopic group [9.5 (4 to 18) vs. 11 (6 to 39)]. Use of patient-controlled analgesia was not significantly shorter in the laparoscopic group [3 (0 to 4) vs. 3.5 (0 to 8)]. Morbidities observed in the LHPR group include a parietal abscess and an anastomotic stenosis without surgical treatment. The OHPR group had 6 complications: 1 anastomotic leak and 5 incisional hernias.
LHPR with a conversion rate of 14.28% seems to be a method with shorter operating time and less morbidity compared with OHPR.
本研究比较了初次治疗腹膜炎（亨奇 III 或 IV 级）患者的开放式哈特曼手术逆转术（OHPR）和腹腔镜哈特曼手术逆转术（LHPR）。
将 2 年内接受 LHPR 的 14 例患者与同一机构先前接受开放式手术的 20 例患者进行比较。
中转率为 14.28%。腹腔镜组的手术时间较短[143（90 至 240）分钟 vs. 180（90 至 350）分钟，P<0.05]。腹腔镜组的住院时间较短[9.5（4 至 18）天 vs. 11（6 至 39）天]。腹腔镜组患者自控镇痛的使用时间无显著缩短[3（0 至 4）天 vs. 3.5（0 至 8）天]。LHPR 组观察到的并发症包括 1 例壁层脓肿和 1 例无需手术治疗的吻合口狭窄。OHPR 组有 6 例并发症：1 例吻合口漏和 5 例切口疝。
与 OHPR 相比，中转率为 14.28%的 LHPR 似乎是一种手术时间较短且发病率较低的方法。
