Analysis of Technical Keypoints of The Second-Phase Diaplasis Treatment after Hartmann Operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIN Liewen , PAN Kai , XIA Ligang

The Second Clinical College of Jinan University, Department of Gastrointestinal Surgery, People’s Hospital of Shenzhen City, Shenzhen 518020, ChinaCorresponding Author: LIN Lie-wen, E-mail: gastrointestinal@163.com;

Corresponding author：

Keywords：

Hartmann operation; Second-phase diaplasis operation

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Objective 　To discuss the technical keypoints of the second-phase diaplasis treatment after Hartmann operation.
Methods　 Twenty-one cases of the second-phase diaplasis operation of Hartmann operation in this hospital from January 2003 to December 2007 were analysed retrospectively.
Results 　In this group, stapler technique was used in 15 cases, anastomotic ring was used in 3 cases, and one-layer suture was used in 3 cases. The time of these operations was between 118 min and 240 min (mean 164 min). Neither stomal leak nor stomal stenosis occurred, acute ileus occurred in 2 cases, and both recovered after the treatments of gastrointestinal decompression, inhibition of secretion digestive juice and reoperation. Acute retension of urine occurred in 1 case after urine catheter removed. The symptoms disappeared after excises of bladder function. These cases were followed up for 3-36 months (mean 20 months). All the patients recovered to normal function of defecation.
Conclusion 　The technical keypoints of the second-phase diaplasis treatment after Hartmann operation are how to find and liberate the end of the distal colon. It will affect the prognosis and the occurrence of complications after this operation.

Citation： LIN Liewen,PAN Kai,XIA Ligang. Analysis of Technical Keypoints of The Second-Phase Diaplasis Treatment after Hartmann Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(10): 765-767. doi: Copy

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1. 　高德明主编. 现代急腹症学 [M]. 第2版. 北京：人民军医出版社， 2002∶780~782.
2. 　王吉甫主编. 胃肠外科学 [M]. 第4版. 北京：人民卫生出版社， 2000∶1139~1140.
3. 　丁仕章. 如何提高直肠癌患者外科治疗的身心康复 [Ｊ]. 结直肠肛门外科杂志， 2006； 12(4)∶247.
4. 　刘连杰, 屠岳, 孟荣贵, 等. 结肠造口还纳术51 例临床分析 [Ｊ]. 中国实用外科杂志, 1999； 19(12)∶734.
5. 　石涧江，杨波. 结肠造口还纳术有关问题的探讨 [Ｊ]. 临床医药实践杂志， 2003； 12（9）∶712.
6. 　任明扬，周家镇，魏成钢，等. 全直肠系膜切除术的临床实践 [Ｊ]. 中国普外基础与临床杂志， 2004； 11（6）∶531.
7. 　汪建平. 结直肠癌外科治疗水平差异的思考 [Ｊ]. 中华胃肠外科杂志， 2006； 9(2)∶93.
8. 　Heald RJ, Chir M, Karanjia NS. Results of radical surgery for rectal cancer [Ｊ]. World J Surg, 1992; 16(5)∶848.
9. 　Law WI , Chu KW, Ho JW, et al. Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision [Ｊ]. Am J Surg, 2000; 179(2)∶92.
10. 　汪建平, 杨祖立. 直肠癌外科治疗的现代解剖学基础 [Ｊ]. 中国实用外科杂志, 2002; 22(6)∶365.
11. 　Soyce WP, Dolan J, Hyland J. The mesorectum: re-appraisal of its morphology and its unique importance in rectal cancer [J]. Int J Colorectal Dis, 1998; 8∶235.
12. 　顾晋. 中低位直肠癌手术盆腔自主神经保护的现状 [Ｊ]. 中国普外基础与临床杂志， 2005； 12（1）∶4.
13. 　顾晋，周永建. 低位直肠癌的诊断与治疗现状 [Ｊ]. 中华胃肠外科杂志， 2004； 7(2)∶90.
14. 　Hojo K, Vernava AM 3rd, Sugihara K, et al. Preservation of urine voiding and sexual function after rectal cancer surgery [Ｊ]. Dis Colon Rectum, 1991; 34（7）∶532.
15. 　Kinn AC, Ohman U. Bladder and sexual function after surgery for rectal cancer [Ｊ]. Dis Colon Rectum, 1986; 29（1）∶43.
16. 　左明，刘宝善，徐琳，等. 低位直肠癌保留神经的腹膜外侧方扩大清扫的效果分析 [Ｊ]. 中国普外基础与临床杂志， 2006； 13（5）∶568.
17. 　张宏，陈春生，乔雷，等. 低位直肠癌双吻合器保肛手术后吻合口漏的预防策略 [Ｊ]. 中国普外基础与临床杂志， 2007； 14（1）∶89.
18. 　邱辉忠. 双吻合技术在低位直肠癌手术中的应用 [Ｊ]. 中国实用外科杂志， 2005； 25（3）∶139.
19. 　Hida J, Yasutomi M, Maruyama T, et al. Indications for colonic J-pouch reconstruction after anterior resection for rectal cancer [Ｊ]. Dis Colon Rectum, 1998; 41∶558.
20. 　赵松寿. 一层吻合在直肠癌前切除术中的应用 [Ｊ]. 贵州医药， 1994； 18(2)∶110.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Technical Keypoints of The Second-Phase Diaplasis Treatment after Hartmann Operation

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