title: Second-look surgery following Hartmann's procedure for obstructive left-sided colorectal cancer.
abstract: The aim of the present study was to investigate the short- and long-term outcomes of patients undergoing second-look surgery following Hartmann's procedure for obstructive left-sided colorectal cancer (LSCC). All patients included in the present study had undergone radical surgery with Hartmann's procedure for obstructive LSCC. Adjuvant chemotherapy was recommended for all patients, and patients with no signs of recurrence following six months of surveillance were planned to undergo second-look surgery. The aim of second-look surgery was early detection of local recurrence and determination of the efficacy of laparoscopic Hartmann procedure reversal. A total of 15 patients with locally advanced colorectal cancer were included in the study. Three patients exhibited peritoneal dissemination at the time of laparoscopic Hartmann procedure reversal and underwent partial peritonectomy. Following adjuvant chemotherapy treatment, laparoscopic Hartmann procedure reversal was performed in all patients. However, two patients underwent colo-anal anastomosis, and two patients underwent right-sided colon or ileum reconstruction. Regarding the oncological outcomes, two of three patients in whom peritoneal dissemination was identified during laparoscopic Hartmann procedure reversal were eventually in remission following the initial surgery and the second-look surgery with partial peritonectomy. Favorable long-term outcomes were observed in 12/15 patients due to no recurrence, which may be due to the surgical techniques used and the timing of the second-look surgery following Hartmann's procedure for the treatment of obstructive LSCC.
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo 663-8186, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Beppu
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo 663-8186, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matsubara
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Noda
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo 663-8186, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yanagi
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo 663-8186, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamanaka
keywords: Hartmann's procedure; adjuvant chemotherapy; obstructive left-sided colorectal cancer; peritoneal dissemination; second-look surgery