A Comparative Study on the Short-Term Clinical Outcomes of Laparoscopic vs. Open Hartmann%26apos;s Procedure for High Risk Patients in Colorectal Cancer

作者：Tashiro Jo^*; Yamaguchi Shigeki; Ishii Toshimasa; Sato Takahiro; Suwa Hirokazu; Okada Ichiro; Kondo Hiroka; Miyazawa Mitsuo; Shinozuka Nozomi; Koyama Isamu

来源：Hepato-Gastroenterology, 2012, 59(117): 1403-1407.

DOI：10.5754/hge11694

• Laparoscopic Hartmann%26apos
• s procedure
• Colorectal cancer
• High risk patient

Background/Aims: Patients with severe co-morbidities and oncological conditions would not be denied a reconstruction of anastomosis and Hartmann%26apos;s procedure would be undertaken. The aim of this study is to examine the feasibility and safety of laparoscopic Hartmann%26apos;s procedure compared to open Hartmann%26apos;s procedure for high risk patients in colorectal cancer. Methodology: Nine hundred and eighty five primary colorectal cancer resections were performed from April 2007 to December 2010. Thirty six patients (3.6%) who underwent Hartmann%26apos;s procedure by the same surgical team were investigated retrospectively. Results: Twenty six patients (72%) in the open surgery (OS) and 10 patients (28%) in the laparoscopic surgery (LS) were undertaken Hartmann%26apos;s procedure. The reason of selected Hartmann%26apos;s procedure was defined as high risk with severe co-morbidities (OS 8: LS 8, n=16), oncological conditions (OS 14: LS 2, n=16), urgent situations (OS 4, n=4). The mean operation time was not significantly different (p=0.504). The median blood loss count was significantly different between both groups (OS 327.5g vs. LS 16.5g; p=0.0001). The incidence of postoperative complications was similar (OS 38% vs. LS 40%; p=0.763). The median postoperative hospital stay was not significantly different (OS 10.5 vs. LS 12; p=0.216). Conclusions: Laparoscopic Hartmann%26apos;s procedure is feasible and safe with a low invasiveness for high risk patients with colorectal cancer.

• 出版日期2012-8