• 作者：Gino Caselli^a ; ^{gcaselli@uc.cl} ; Claudia Bambs^a ; ^b ; George Pinedo^a ; Marí ; a Elena Molina^a ; Alvaro Zú ; ñ ; iga^a ; Felipe Bellolio^a
• 关键词：Operació ; n de Hartmann ; Laparoscopia ; Reconstrucció ; n de trá ; nsito
• 刊名：Cirug铆a Espa帽ola
• 出版年：2010
• 期刊代码：pca87_0009739X
• 类别：med
• 出版时间：November 2010
• 卷：88
• 期：5
• 页码：314-318
• 文件大小：151 K

Introduction

Intestinal passage reconstruction after Hartmann's (PRH) operation is associated with a high morbidity and mortality of about 1%. Despite the increasing use of laparoscopy as an alternative in PRH, there is a lack of patient series at international level.

Patients and methods

The prospective series of patients subjected to (PRH) by laparoscopy was analysed using the demographic parameters, ASA classification, reason for primary surgery, time between initial surgery and reconstruction, operation time, conversion to open surgery, bowel rest recovery time, complications, hospital stay and follow up.

Results

A total of 30 patients with a mean age of 61.5卤13 years were operated on using laparoscopy. The ASA classification was 1.8卤0.3 the BMI was 26.1卤2 Kg/m². A total of 63%were admitted due to complicated Hinchley III or IV acute diverticulitis. The interval between initial surgery and the passage reconstruction was 7.1卤2 months. Conversion to open surgery was necessary in three cases. The mean intestinal passage recovery was 2.1卤1 days and the hospital stay was 5.6卤1 days. The long-term complications were one mechanic ileum due to bridles and one case of anastomotic stenosis.

Conclusions

The post-Hartmann laparoscopic passage reconstruction is associated with a short intestinal motility recovery time, as well as a less prolonged hospital stay compared to an open surgery series. Randomised studies are needed to determine whether laparoscopic reconstruction is superior to the conventional technique.