Laparoscopic-assisted reversal of Hartmann's procedure.
BACKGROUND
Postoperative morbidity after reversal of Hartmann's procedure remains high.


OBJECTIVE
to evaluate efficacy of laparoscopic-assisted approach.


METHODS
36 patients (19 men, aged 55.71 +/- 1.5 years) underwent laparoscopic-assisted reversal procedures in May 2008 - June 2010. The comparable control group consisted of 35 patients (16 men, aged 51.5 +/- 13.9 years).


RESULTS
operation time was 179.5 +/- 65.1 min, 266.9 +/- 71.8 min in controls. Blood loss was 64.7 +/- 33.7 ml, 181.8 +/- 120.4 ml in controls. No conversions occurred in the main group. In three patients of the main group preventive ileostomy was performed. There were 11 diverting stomas in the control group. Postoperative hospital stays were 9.1 +/- 2.7 days (12.9 +/- 3.4 days in controls). There were 2 (5.9%) postoperative complications in the main group: one wound infection and one parastomal fistula. No mortality occurred. In the control group 3 (9.1%) complications (wound infection and haematoma) were detected.


CONCLUSIONS
laparoscopic-assisted reversal of Hartmann's procedure promotes faster rehabilitation, its results are not worse than after open approach.
State Science Center of Coloproctology, Moscow.
S
S
Achkasov
G
G
Vorobiev
A
A
Zhuchenko
M
M
Rinchinov
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003106:Colon / Q000601:surgery*; D003125:Colostomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications