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A comparative study on the short-term clinical outcomes of laparoscopic versus open Hartmann's procedure for high risk patients in colorectal cancer.

Research paper by Jo J Tashiro, Shigeki S Yamaguchi, Toshimasa T Ishii, Takahiro T Sato, Hirokazu H Suwa, Ichiro I Okada, Hiroka H Kondo, Mitsuo M Miyazawa, Nozomi N Shinozuka, Isamu I Koyama

Indexed on: 26 Nov '11Published on: 26 Nov '11Published in: Hepato-gastroenterology



Abstract

Patients with severe co-morbidities and oncological conditions would not be denied a reconstruction of anastomosis and Hartmann's procedure would be undertaken. The aim of this study is to examine the feasibility and safety of laparoscopic Hartmann's procedure compared to open Hartmann's procedure for high risk patients in colorectal cancer.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's procedure by the same surgical team were investigated retrospectively.Twenty six patients (72%) in the open surgery (OS) and 10 patients (28%) in the laparoscopic surgery (LS) were undertaken Hartmann's procedure. The reason of selected Hartmann'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).Laparoscopic Hartmann's procedure is feasible and safe with a low invasiveness for high risk patients with colorectal cancer.