腹腔镜哈特曼逆转术:发展中国家的单中心经验

Emad M. Abdelrahman, Sherif M. ElKaffas, Mohamed I. Abuelnasr
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摘要

.摘要 背景:在结直肠手术中,哈特曼翻转术是最棘手的技术之一。吻合口的渗漏率各不相同。腹腔镜哈特曼逆转术(LHR)等微创手术因发病率较低而越来越受欢迎。本研究旨在报告本院在 LHR 方面的经验。患者和方法:本前瞻性随机研究包括 62 名符合 HR 条件的患者。患者被随机分配为两组。A 组(31 人)接受 LHR,B 组接受开放哈特曼逆转术。计划随访至少 6 个月。结果A 组和 B 组的平均年龄分别为(45.72±15.12)岁和(42.66±14.91)岁。B组平均手术时间更长,平均失血量更多,差异有统计学意义(P≤0.001),住院时间明显更长。与 A 组相比,B 组的术后并发症包括伤口感染、裂开、血清肿、肠漏、回肠炎和切口疝更为明显(P≤0.001)。结论为患者精心选择的微创手术(HR)是一项安全、有益的技术,可提高患者的生活质量。患者可从微创手术中获益良多,如手术时间更短,恢复更快,预计失血量更少,排便时间更短,术后疼痛更轻,住院时间更短。
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Laparoscopic Hartmann reversal: A single center experience in a developing country
. ABSTRACT Background: In colorectal surgery, one of the trickiest techniques is the Hartmann reversal. The rate of anastomosis leaking varies. Minimally invasive surgeries like laparoscopic Hartmann reversal (LHR) have become more popular because of lower morbidities. The aim of this study was to report our institutional experience in LHR. Patients and Methods: The current prospective randomized study included 62 patients who were eligible for HR. Patients were randomly allocated into two equal groups. Group A (n=31) underwent LHR, while group B underwent open Hartmann reversal. Follow-up was planned for at least 6 months. Results: The mean age was 45.72±15.12 and 42.66±14.91 in groups A and B, respectively. There was a statistically significant longer mean operative time with more mean blood loss in group B ( P≤0.001 ) with a significantly longer hospital stay. The postoperative complications, including wound infection, dehiscence, seroma, intestinal leak, ileus, and incisional hernia, were evident in group B when compared to group A ( P≤0.001 ). Conclusion: Well-chosen patient makes (HR) a safe and beneficial technique for improving a patient’s quality of life. Patients can get substantial benefits with minimally invasive procedures, such as a quicker recovery with fewer operating hours, less projected blood loss, a shorter time to flatus, less pain following surgery, and a shorter hospital stay.
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