Restoration of intestinal continuity following Hartmann's procedure: The Lothian experience 1987-1992
Restoration of intestinal continuity following Hartmann's procedure is associated with high morbidity (anastomotic leak rates 4–16 per cent) and mortality (0–4 per cent) rates. A total of 178 patients, under the care of seven different surgical units, underwent reversal of Hartmann's proce...
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| Veröffentlicht in: | British journal of surgery 1995-01, Vol.82 (1), p.27-30 |
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| container_title | British journal of surgery |
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| creator | Wigmore, S. J. Duthie, G. S. Young, I. E. Spalding, E. M. Rainey, J. B. |
| description | Restoration of intestinal continuity following Hartmann's procedure is associated with high morbidity (anastomotic leak rates 4–16 per cent) and mortality (0–4 per cent) rates. A total of 178 patients, under the care of seven different surgical units, underwent reversal of Hartmann's procedure during a 5‐year period, representing the largest series yet reported. The mortality rate of the study group was 0·6 per cent, the anastomotic leak rate was 3·9 per cent and the incidence of anastomotic stricture was 6·7 per cent. The median time interval between resection and reversal was 92 days and no relation was found between timing and complications. Anastomotic stricture occurred significantly more commonly in stapled than in sutured anastomoses (P |
| doi_str_mv | 10.1002/bjs.1800820110 |
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J. ; Duthie, G. S. ; Young, I. E. ; Spalding, E. M. ; Rainey, J. B.</creator><creatorcontrib>Wigmore, S. J. ; Duthie, G. S. ; Young, I. E. ; Spalding, E. M. ; Rainey, J. B.</creatorcontrib><description>Restoration of intestinal continuity following Hartmann's procedure is associated with high morbidity (anastomotic leak rates 4–16 per cent) and mortality (0–4 per cent) rates. A total of 178 patients, under the care of seven different surgical units, underwent reversal of Hartmann's procedure during a 5‐year period, representing the largest series yet reported. The mortality rate of the study group was 0·6 per cent, the anastomotic leak rate was 3·9 per cent and the incidence of anastomotic stricture was 6·7 per cent. The median time interval between resection and reversal was 92 days and no relation was found between timing and complications. Anastomotic stricture occurred significantly more commonly in stapled than in sutured anastomoses (P <0·05); however, leaks were equally common in both types. The mean age of the patients who developed major complications was not statistically different from that of the rest of the study group and there was no difference in premorbid state. The authors believe that the low complication rates reported in this series may be attributable to the high level of operator experience in performing this technically difficult procedure, which was done by a consultant in 66 per cent of cases and by a senior registrar in 33 per cent.</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.1800820110</identifier><identifier>PMID: 7881946</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Bristol: John Wiley & Sons, Ltd</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Anastomosis, Surgical - adverse effects ; Anastomosis, Surgical - methods ; Anastomosis, Surgical - mortality ; Biological and medical sciences ; Colon, Sigmoid - surgery ; Female ; Humans ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Rectum - surgery ; Reoperation - mortality ; Scotland ; Stomach, duodenum, intestine, rectum, anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Surgical Wound Dehiscence - mortality</subject><ispartof>British journal of surgery, 1995-01, Vol.82 (1), p.27-30</ispartof><rights>Copyright © 1995 British Journal of Surgery Society Ltd.</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3470-b772ef477ca18ba5c82ab67930d46334f7420b825a692c9d60abb02bde6c07973</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.1800820110$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.1800820110$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,1417,4050,4051,23930,23931,25140,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3425080$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7881946$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wigmore, S. J.</creatorcontrib><creatorcontrib>Duthie, G. S.</creatorcontrib><creatorcontrib>Young, I. E.</creatorcontrib><creatorcontrib>Spalding, E. M.</creatorcontrib><creatorcontrib>Rainey, J. B.</creatorcontrib><title>Restoration of intestinal continuity following Hartmann's procedure: The Lothian experience 1987-1992</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Restoration of intestinal continuity following Hartmann's procedure is associated with high morbidity (anastomotic leak rates 4–16 per cent) and mortality (0–4 per cent) rates. A total of 178 patients, under the care of seven different surgical units, underwent reversal of Hartmann's procedure during a 5‐year period, representing the largest series yet reported. The mortality rate of the study group was 0·6 per cent, the anastomotic leak rate was 3·9 per cent and the incidence of anastomotic stricture was 6·7 per cent. The median time interval between resection and reversal was 92 days and no relation was found between timing and complications. Anastomotic stricture occurred significantly more commonly in stapled than in sutured anastomoses (P <0·05); however, leaks were equally common in both types. The mean age of the patients who developed major complications was not statistically different from that of the rest of the study group and there was no difference in premorbid state. The authors believe that the low complication rates reported in this series may be attributable to the high level of operator experience in performing this technically difficult procedure, which was done by a consultant in 66 per cent of cases and by a senior registrar in 33 per cent.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Anastomosis, Surgical - methods</subject><subject>Anastomosis, Surgical - mortality</subject><subject>Biological and medical sciences</subject><subject>Colon, Sigmoid - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Rectum - surgery</subject><subject>Reoperation - mortality</subject><subject>Scotland</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Surgical Wound Dehiscence - mortality</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFUElP4zAUthCIKct1biP5gMQp8GwnXrhRdlSB2DRHy3YcMKROZaeC_nuCWpXTW77l6X0I_SVwRADosX3PR0QCSAqEwAYaEcarghIuN9EIAERBGGV_0E7O7wCEQUW30baQkqiSj5B_9LnvkulDF3HX4BD7YRGiabHr4tDMQ7_ATde23WeIr_japH5qYjzMeJY65-t58if4-c3jSde_BROx_5r5FHx0HhMlh_NK0T201Zg2-_1V3UUvlxfPZ9fF5P7q5ux0UjhWCiisENQ3pRDOEGlN5SQ1lgvFoC45Y2UjSgpW0spwRZ2qORhrgdracwdCCbaL_i19Z3M79bWepTA1aaFX7w74wQo32Zm2SSa6kNc0VtIKJAw0taR9htYv1jAB_RO5HiLXv5Hr8e3T7zRoi6U25N5_rbUmfWgumKj0_7srfTemD-fwwDRn3w4MgxM</recordid><startdate>199501</startdate><enddate>199501</enddate><creator>Wigmore, S. J.</creator><creator>Duthie, G. S.</creator><creator>Young, I. 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B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3470-b772ef477ca18ba5c82ab67930d46334f7420b825a692c9d60abb02bde6c07973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomosis, Surgical - adverse effects</topic><topic>Anastomosis, Surgical - methods</topic><topic>Anastomosis, Surgical - mortality</topic><topic>Biological and medical sciences</topic><topic>Colon, Sigmoid - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Rectum - surgery</topic><topic>Reoperation - mortality</topic><topic>Scotland</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Surgical Wound Dehiscence - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wigmore, S. J.</creatorcontrib><creatorcontrib>Duthie, G. S.</creatorcontrib><creatorcontrib>Young, I. E.</creatorcontrib><creatorcontrib>Spalding, E. M.</creatorcontrib><creatorcontrib>Rainey, J. B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wigmore, S. J.</au><au>Duthie, G. S.</au><au>Young, I. E.</au><au>Spalding, E. M.</au><au>Rainey, J. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Restoration of intestinal continuity following Hartmann's procedure: The Lothian experience 1987-1992</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1995-01</date><risdate>1995</risdate><volume>82</volume><issue>1</issue><spage>27</spage><epage>30</epage><pages>27-30</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Restoration of intestinal continuity following Hartmann's procedure is associated with high morbidity (anastomotic leak rates 4–16 per cent) and mortality (0–4 per cent) rates. A total of 178 patients, under the care of seven different surgical units, underwent reversal of Hartmann's procedure during a 5‐year period, representing the largest series yet reported. The mortality rate of the study group was 0·6 per cent, the anastomotic leak rate was 3·9 per cent and the incidence of anastomotic stricture was 6·7 per cent. The median time interval between resection and reversal was 92 days and no relation was found between timing and complications. Anastomotic stricture occurred significantly more commonly in stapled than in sutured anastomoses (P <0·05); however, leaks were equally common in both types. The mean age of the patients who developed major complications was not statistically different from that of the rest of the study group and there was no difference in premorbid state. The authors believe that the low complication rates reported in this series may be attributable to the high level of operator experience in performing this technically difficult procedure, which was done by a consultant in 66 per cent of cases and by a senior registrar in 33 per cent.</abstract><cop>Bristol</cop><pub>John Wiley & Sons, Ltd</pub><pmid>7881946</pmid><doi>10.1002/bjs.1800820110</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Anastomosis, Surgical - adverse effects Anastomosis, Surgical - methods Anastomosis, Surgical - mortality Biological and medical sciences Colon, Sigmoid - surgery Female Humans Length of Stay Male Medical sciences Middle Aged Rectum - surgery Reoperation - mortality Scotland Stomach, duodenum, intestine, rectum, anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Surgical Wound Dehiscence - mortality |
| title | Restoration of intestinal continuity following Hartmann's procedure: The Lothian experience 1987-1992 |
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