MODIFIED DUHAMEL PROCEDURE AS A METHOD OF RECONSTRUCTIVE COLON SURGERY AFTER HARTMANN PROCEDURE

Abstract

Objective: to evaluate the efficacy and safety of a new method for restoration of intestinal continuity after Hartmann procedure in patients with rectal cancer. Materials and methods . We analyzed the results of reconstructive surgeries in patients that underwent obstructive resection of the rectum for rectal cancer between 1991 and 2011. We included patients with a rectal stump located under the pelvic peritoneum (its mean length was 8 (4–11) cm). All study participants underwent modified Duhamel procedure. We evaluated demographic characteristics of patients, as well as early and late postoperative complications. Results. A total of 9 patients were treated with this method. Median time between the resection and reconstructive surgery was 13.2 months; median surgery duration was 255 min; median blood loss was 800 mL. One patient had an intraoperative complication (spleen injury). Early postoperative complications were observed in 2 (22.2 %) participants; of them, 1 (50 %) patient had necrosis of the brought-out bowel. One patient (11.1 %) developed anastomosis stricture 6 months post surgery. Conclusion. We developed a new method to restore intestinal continuity after Hartmann procedure. None of the patients had complications associated with rectal stump isolation. The efficiency of this method should be confirmed by larger studies.