CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(02): 117-123
DOI: 10.1055/s-0041-1730013
Original Article|Artigo Original

Effects of Laparoscopic Hartmann Reversal on Short-term Operative Outcomes Among Vietnamese Patients

Resultados da reversão precoce da cirurgia de Hartmann em pacientes vietnamitas
1  Department of Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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2  University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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3  Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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3  Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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4  Faculty of Nursing, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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2  University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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2  University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
› Author Affiliations

Abstract

Background The reestablishment of continuity after Hartmann operation is considered a major surgical procedure with high morbidity and mortality. The optimal interval time between the Hartman procedure and reversal is controversial. Our study aimed to evaluate the effectiveness of laparoscopic Hartmann reversal and to determine the optimal timing of operation.

Methods All patients who underwent laparoscopic Hartmann reversal from 2008 to 2019 (11 years) at the University Medical Center (UMC) in Ho Chi Minh City were recruited and divided into 2 groups according to the interval time (≤ 4 or > 4 months). The short-term operative outcomes of these groups were compared.

Results There were 66 patients who underwent laparoscopic Hartmann reversal (mean age: 63.2 years old); ∼ 77% of them had colorectal cancer, and 17% had complicated diverticular disease. The mortality rate, anastomotic leakage rate, and overall complication rate were 0%, 1.5%, and 13.2%, respectively. Early operation was performed in 36 patients, and late reversal in 28 patients. There was no difference in mortality, anastomotic leakage, operative complications, and hospital stay between the two groups.

Conclusion Laparoscopic Hartmann reversal was effective with acceptable morbidity and mortality at the UMC. There was no observed impact of the interval time between the Hartmann procedure and laparoscopic Hartmann reversal on the short-term operative outcomes.

Resumo

Introdução O reestabelecimento da continuidade após a cirurgia de Hartmann é considerado um procedimento cirúrgico de grande porte com altas morbidade e mortalidade. O tempo ideal de intervalo entre a cirurgia de Hartmann e a reversão é controverso. Nosso estudo teve como objetivo avaliar a eficácia da reversão da cirurgia de Hartmann e determinar o momento ideal para a cirurgia.

Métodos Todos os pacientes submetidos à reversão laparoscópica da cirurgia de Hartmann entre 2008 e 2019 (11 anos) no Centro Médico Universitário (UMC, na sigla em inglês) na cidade de Ho Chi Minh foram recrutados e divididos em 2 grupos de acordo com o tempo de intervalo (≤ 4 ou > 4 meses). Os resultados pós-operatórios de curto prazo destes grupos foram comparados.

Resultados Um total de 66 pacientes foram submetidos à reversão laparoscópica da cirurgia de Hartmann (mediana de idade: 63.2 anos); ∼ 77 deles tinha câncer colorretal, e 17% tinham doença diverticular complicada. As taxas de mortalidade, de vazamento, e de complicações em geral foram de 0%, 1,5%, e 13,2%, respectivamente. Cirurgia precoce foi realizada em 36 pacientes, e reversão tardia foi realizada em 28 pacientes. Não houve diferença em mortalidade, vazamento anastomótico, complicações operatórias e duração da internação entre os dois grupos.

Conclusão A reversão laparoscópica da cirurgia de Hartmann foi eficaz, com morbidade e mortalidade aceitáveis no UMC. Não foi observado qualquer impacto no tempo de intervalo entre a cirurgia de Hartmann e a reversão laparoscópica nos resultados pós-operatórios de curto prazo.

Credit Author Statement

Bac N. H.: Conceptualization, writing- reviewing and editing. Viet U. V.: Methodology, data curation, data analysis, writing; preparation of the original draft. Tan P. V.: Data analysis, writing- reviewing and editing. Bang H. C.: Data analysis, writing- reviewing and editing. Trung V. N: Writing-reviewing and editing. Dang T. N.: Data analysis, writing-reviewing and editing. Vinh L. C.: Writing-reviewing and editing.


Funding

The present research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


Supplementary Material



Publication History

Received: 09 June 2020

Accepted: 15 January 2020

Publication Date:
30 June 2021 (online)

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