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Reversal of Hartmann's procedure after perforated diverticulitis through the stomal side without additional incisions: the SIR procedure.
Dig Surg 2010; 27(5):391-6DS

Abstract

AIMS

Reversal of Hartmann's procedure (HP) is a complex operation and only performed in 50-60% of the patients. Stomal incision reversal (SIR), a new minimally invasive procedure for HP reversal, was assessed and compared to the standard surgical approach.

METHODS

16 patients who had undergone HP for perforated diverticulitis underwent HP reversal by SIR. The only incision in SIR is the one to release the end colostomy. Intra-abdominal adhesiolysis is done manually. A stapled end-to-end colorectal anastomosis is created. The 16 patients who underwent SIR were compared with 32 control patients who were matched according to gender, age, American Society of Anesthesiologists (ASA) classification and Hinchey stage.

RESULTS

The operation time was shorter after SIR than after reversal by laparotomy [75 min (58-208) vs. 141 min (85-276); p < 0.001]. Patients after SIR had a shorter hospital stay than patients after laparotomy [4 days (2-22) vs. 9 days (4-64); p < 0.001]. The numbers of total postoperative surgical complications (early and late) were not different (p = 0.13). The anastomotic leakage rate was similar in both groups (6%). The conversion rate in the SIR group was 19% (n = 3).

CONCLUSION

SIR compared favorably with HP reversal by laparotomy in terms of operation time and hospital stay, without increasing the number of postoperative complications.

Authors+Show Affiliations

Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands. VermeulenJ@maasstadziekenhuis.nlNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20938183

Citation

Vermeulen, J, et al. "Reversal of Hartmann's Procedure After Perforated Diverticulitis Through the Stomal Side Without Additional Incisions: the SIR Procedure." Digestive Surgery, vol. 27, no. 5, 2010, pp. 391-6.
Vermeulen J, Leijtens JW, Mannaerts GH. Reversal of Hartmann's procedure after perforated diverticulitis through the stomal side without additional incisions: the SIR procedure. Dig Surg. 2010;27(5):391-6.
Vermeulen, J., Leijtens, J. W., & Mannaerts, G. H. (2010). Reversal of Hartmann's procedure after perforated diverticulitis through the stomal side without additional incisions: the SIR procedure. Digestive Surgery, 27(5), pp. 391-6. doi:10.1159/000319323.
Vermeulen J, Leijtens JW, Mannaerts GH. Reversal of Hartmann's Procedure After Perforated Diverticulitis Through the Stomal Side Without Additional Incisions: the SIR Procedure. Dig Surg. 2010;27(5):391-6. PubMed PMID: 20938183.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reversal of Hartmann's procedure after perforated diverticulitis through the stomal side without additional incisions: the SIR procedure. AU - Vermeulen,J, AU - Leijtens,J W A, AU - Mannaerts,G H H, Y1 - 2010/10/13/ PY - 2010/03/05/received PY - 2010/07/10/accepted PY - 2010/10/13/entrez PY - 2010/10/13/pubmed PY - 2011/3/17/medline SP - 391 EP - 6 JF - Digestive surgery JO - Dig Surg VL - 27 IS - 5 N2 - AIMS: Reversal of Hartmann's procedure (HP) is a complex operation and only performed in 50-60% of the patients. Stomal incision reversal (SIR), a new minimally invasive procedure for HP reversal, was assessed and compared to the standard surgical approach. METHODS: 16 patients who had undergone HP for perforated diverticulitis underwent HP reversal by SIR. The only incision in SIR is the one to release the end colostomy. Intra-abdominal adhesiolysis is done manually. A stapled end-to-end colorectal anastomosis is created. The 16 patients who underwent SIR were compared with 32 control patients who were matched according to gender, age, American Society of Anesthesiologists (ASA) classification and Hinchey stage. RESULTS: The operation time was shorter after SIR than after reversal by laparotomy [75 min (58-208) vs. 141 min (85-276); p < 0.001]. Patients after SIR had a shorter hospital stay than patients after laparotomy [4 days (2-22) vs. 9 days (4-64); p < 0.001]. The numbers of total postoperative surgical complications (early and late) were not different (p = 0.13). The anastomotic leakage rate was similar in both groups (6%). The conversion rate in the SIR group was 19% (n = 3). CONCLUSION: SIR compared favorably with HP reversal by laparotomy in terms of operation time and hospital stay, without increasing the number of postoperative complications. SN - 1421-9883 UR - https://www.unboundmedicine.com/medline/citation/20938183/Reversal_of_Hartmann's_procedure_after_perforated_diverticulitis_through_the_stomal_side_without_additional_incisions:_the_SIR_procedure_ L2 - https://www.karger.com?DOI=10.1159/000319323 DB - PRIME DP - Unbound Medicine ER -