Panaccio Paolo, Grottola Tommaso, Percario Rossana, Selvaggi Federico, Cericola Severino, Lapergola Alfonso, Farrukh Maira, Martino Giuseppe Di, Ricciardiello Marco, Di Sebastiano Pierluigi, Di Mola Fabio Francesco
Department of Medicine and Oral Sciences and Biotechnologies, Unit of General and Oncology Surgery, Casa Di Cura Pierangeli, University G. D'Annunzio, Chieti-Pescara, Italy.
Department of Medicine and Oral Sciences and Biotechnologies, University G. D'Annunzio, Chieti-Pescara, Italy.
Surg Res Pract. 2021 Jan 23;2021:4547537. doi: 10.1155/2021/4547537. eCollection 2021.
Laparoscopic reversal of Hartmann's procedure (LHR) offers reduced morbidity compared with open Hartmann's reversal (OHR). The aim of this study is to compare the outcome of laparoscopic versus open Hartmann reversal.
Thirty-four patients who underwent Hartmann reversal between January 2017 and July 2019 were evaluated. Patients underwent either LHR ( = 17) or OHR ( = 17). Variables such as numbers of patients, patient's age, sex, body mass index (BMI), comorbidities, ASA (American Society of Anesthesiology) score, indication for previous open sigmoid resection, mean operation time, rate of conversion to open surgery, length of hospital stay, mortality, and morbidity were retrospectively evaluated.
The two groups of patients were homogeneous for gender, age, body mass index, cause of primary surgery, time to reversal, and comorbidities. In 97% of the cases, HP was done by open surgery. Our data revealed no difference in mean operation time (LHR: 180.5 ± 35.1 vs. OHR: 225.2 ± 48.4) and morbidity rate, although, in OHR group, there were more severe complications. Less intraoperative blood loss (LHR: 100 ± 40 mL vs. OHR: 450 ± 125 mL; value <0.001), shorter time to flatus (LHR: 2.4 days vs. OHR: 3.6 days; value <0.021), and shorter hospitalization (LHR: 4.4 vs. OHR: 11.2 days; value <0.001) were observed in the LHR group. Mortality rate was null in both groups. . LHR is feasible and safe even for patients who received a primary open Hartmann's procedure. We suggest careful patient's selection allowing LHR procedures to highly skilled laparoscopy surgeons.
与开腹哈特曼手术回纳术（OHR）相比，腹腔镜下哈特曼手术回纳术（LHR）的发病率更低。本研究的目的是比较腹腔镜与开腹哈特曼手术回纳术的结果。
对2017年1月至2019年7月期间接受哈特曼手术回纳术的34例患者进行评估。患者接受LHR（n = 17）或OHR（n = 17）。对患者数量、患者年龄、性别、体重指数（BMI）、合并症、美国麻醉医师协会（ASA）评分、既往开腹乙状结肠切除术的指征、平均手术时间、转为开腹手术的比率、住院时间、死亡率和发病率等变量进行回顾性评估。
两组患者在性别、年龄、体重指数、初次手术原因、回纳时间和合并症方面具有同质性。在97%的病例中，哈特曼手术是通过开放手术完成的。我们的数据显示，平均手术时间（LHR：180.5±35.1 vs. OHR：225.2±48.4）和发病率没有差异，尽管在OHR组中，有更严重的并发症。LHR组术中失血量更少（LHR：100±40 mL vs. OHR：450±125 mL；P值<0.001），排气时间更短（LHR：2.4天 vs. OHR：3.6天；P值<0.021），住院时间更短（LHR：4.4天 vs. OHR：11.2天；P值<0.001）。两组死亡率均为零。LHR即使对于接受初次开腹哈特曼手术的患者也是可行且安全的。我们建议仔细选择患者，让高技能的腹腔镜外科医生进行LHR手术。
