PATIENT SAFETY DURING HARMTANN REVERSAL PROCEDURES

Abstract

Hartmann procedure is the most often applied operation in urgent or complicated surgical diseases of the left colon and rectum. Nowadays remains the “gold standard”. Not all the patients however, can reach to a reversal procedure, because of many different reasons like the general condition of the patient or features related to the main disease. The reversal procedure is not fully safe and it is linked with various complications, such as anastomotic leak, postoperative ileus, enterocutaneous fistula and wound infection. Regardless of the development of medicine, the reversal procedure is accompanied with significant morbidity and mortality.
Purpose of our study is to explore the safety and feasibility of mini-invasive and conventional techniques of the Hartmann reversal procedure.

In the present topic we examined 8-year period of time for patients that underwent reversal procedures in the Surgical Department of UMHAT “Eurohospital Plovdiv”. During this period we had 41 patients. Minimally invasive approach we used in 18 of the cases, from whom we had 4 conversions. The received data we analyzed by several main criteria: primary disease, type of operation, reasons for conversion, early and late complications, and hospital length stay.

Hartmann reversal procedure is still an object of interest, especially after the turbulent incursion of the mini-invasive surgery. This type of operations is accompanied by a significant morbidity and mortality, wherefore it is necessary the precise selection of patients for this procedure. In well selected patients, the laparoscopic surgery is fully applicable and it leads to a better early postoperative results as opposed to the conventional one.