title: A comparative study on the short-term clinical outcomes of laparoscopic versus open Hartmann's procedure for high risk patients in colorectal cancer.
abstract: OBJECTIVE
  Patients with severe co-morbidities and oncological conditions would not be denied a reconstruction of anastomosis and Hartmann's procedure would be undertaken. The aim of this study is to examine the feasibility and safety of laparoscopic Hartmann's procedure compared to open Hartmann's procedure for high risk patients in colorectal cancer.
  
  
  METHODS
  Nine hundred and eighty five primary colorectal cancer resections were performed from April 2007 to December 2010. Thirty six patients (3.6%) who underwent Hartmann's procedure by the same surgical team were investigated retrospectively.
  
  
  RESULTS
  Twenty six patients (72%) in the open surgery (OS) and 10 patients (28%) in the laparoscopic surgery (LS) were undertaken Hartmann's procedure. The reason of selected Hartmann's procedure was defined as high risk with severe co-morbidities (OS 8: LS 8, n=16), oncological conditions (OS 14: LS 2, n=16), urgent situations (OS 4, n=4). The mean operation time was not significantly different (p=0.504). The median blood loss count was significantly different between both groups (OS 327.5g vs. LS 16.5g; p=0.0001). The incidence of postoperative complications was similar (OS 38% vs. LS 40%; p=0.763). The median postoperative hospital stay was not significantly different (OS 10.5 vs. LS 12; p=0.216).
  
  
  CONCLUSIONS
  Laparoscopic Hartmann's procedure is feasible and safe with a low invasiveness for high risk patients with colorectal cancer.
authors: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan. tashiro@saitama-med.ac.jp
authors: Jo
authors: J
authors: Tashiro
authors: Shigeki
authors: S
authors: Yamaguchi
authors: Toshimasa
authors: T
authors: Ishii
authors: Takahiro
authors: T
authors: Sato
authors: Hirokazu
authors: H
authors: Suwa
authors: Ichiro
authors: I
authors: Okada
authors: Hiroka
authors: H
authors: Kondo
authors: Mitsuo
authors: M
authors: Miyazawa
authors: Nozomi
authors: N
authors: Shinozuka
authors: Isamu
authors: I
authors: Koyama
mesh_terms: D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome