[Reconversion after Hartmann's procedure. Our experience].
An increasing number of intestinal reconversion after Hartmann have been performed in recent years, especially due to improved surgical techniques and progressively lengthened lifespan. The authors report 33 cases of intestinal recanalization of 100 interventions according to Hartmann from 1984 to 1996 (21 not neoplastic pathologies, 12 neoplasias). The variables considered included: patient age, type of disease requiring intervention according to Hartmann, oncologic characteristic of patients with neoplasia, interval between the two interventions, preoperative examinations performed, morbidity and mortality after reconversion. Furthermore, the fundamental indications for reconversion are described, in particular in patients with neoplasias (CEA, transanal echo, total body Ct, anal manometry). The low frequency of preoperative complications, zero mortality, satisfactory long-term follow-up (only one patient with neoplastic relapse) indicate that colon-rectal reconversion can also be performed in the elderly and patients with neoplasias with favorable prognosis.
Benedetti
M
M
Istituto di Chirurgia Generale e dei Trapianti d'Organo Patologia Chirurgica II, IRCCS Policlinico S. Matteo, Università degli Studi di Pavia.
Marchesi
R
R
Zanardi
A
A
Pastorelli
A
A
Scicchitano
D
D
Castagnoli
L
L
Pandolfi
U
U
Tinozzi
S
S
D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged