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Second-look surgery following Hartmanns procedure for obstructive left-sided colorectal cancer

机译:Hartmann手术治疗梗阻性左侧结直肠癌的二眼手术

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摘要

The aim of the present study was to investigate the short- and long-term outcomes of patients undergoing second-look surgery following Hartmann's procedure for obstructive left-sided colorectal cancer (LSCC). All patients included in the present study had undergone radical surgery with Hartmann's procedure for obstructive LSCC. Adjuvant chemotherapy was recommended for all patients, and patients with no signs of recurrence following six months of surveillance were planned to undergo second-look surgery. The aim of second-look surgery was early detection of local recurrence and determination of the efficacy of laparoscopic Hartmann procedure reversal. A total of 15 patients with locally advanced colorectal cancer were included in the study. Three patients exhibited peritoneal dissemination at the time of laparoscopic Hartmann procedure reversal and underwent partial peritonectomy. Following adjuvant chemotherapy treatment, laparoscopic Hartmann procedure reversal was performed in all patients. However, two patients underwent colo-anal anastomosis, and two patients underwent right-sided colon or ileum reconstruction. Regarding the oncological outcomes, two of three patients in whom peritoneal dissemination was identified during laparoscopic Hartmann procedure reversal were eventually in remission following the initial surgery and the second-look surgery with partial peritonectomy. Favorable long-term outcomes were observed in 12/15 patients due to no recurrence, which may be due to the surgical techniques used and the timing of the second-look surgery following Hartmann's procedure for the treatment of obstructive LSCC.
机译:本研究的目的是调查在接受Hartmann手术治疗的阻塞性左侧结直肠癌(LSCC)术后接受二次手术的患者的短期和长期结局。本研究中包括的所有患者均接受了采用Hartmann手术治疗阻塞性LSCC的根治性手术。建议对所有患者进行辅助化疗,并且在监测六个月后无复发迹象的患者计划接受第二次手术。二次手术的目的是早期发现局部复发并确定腹腔镜Hartmann手术逆转的疗效。该研究总共包括15例局部晚期结肠直肠癌患者。 3例患者在腹腔镜Hartmann手术逆转时表现出腹膜扩散,并接受了部分腹膜切除术。辅助化疗后,对所有患者进行腹腔镜Hartmann手术逆转。但是,两名患者接受了肛门肛门吻合术,两名患者接受了右侧结肠或回肠重建术。关于肿瘤学结局,在腹腔镜Hartmann手术逆转过程中发现腹膜播散的三位患者中,有两位在部分外科腹膜切除术的初始手术和第二眼手术后最终缓解。由于没有复发,因此在12/15的患者中观察到了良好的长期结果,这可能是由于所使用的手术技术以及采用Hartmann手术治疗阻塞性LSCC后进行第二次手术的时机所致。

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