Clinical Effect Of Laparoscopy In Hartmann Reversal

Objective:The clinical data of 70 patients with colorectal cancer who underwent laparoscopic-assisted hartmann reversal were retrospectively analyzed to investigate the safety,effectiveness and advantages and disadvantages of laparoscopic-assisted hartmann reversal in planned secondary surgery.It is expected to provide a basis for choosing a reasonable surgical method in the future.Methods:The clinical data of 70 patients with colorectal cancer who underwent laparoscopic-assisted hartmann reversal in this study are selected from January 2015 to December 2020 in our hospital.These clinical data include gender,age,body mass index,operation interval,tumor stage,postoperative chemotherapy or not,preoperative complications,gastrointestinal function recovery time,drainage tube indwelling time,drainage tube drainage volume,and incidence of complication incisions,incision pain score,postoperative hospital stay,total hospitalization expenses,etc.These clinical datas are statistically analyzed using SPSS 25.0 software.According to different surgical methods,it is divided into laparoscopic group(receiving laparoscopic-assisted hartmann reversal)and traditional laparotomy group(receiving traditional open hartmann reversal),including 30 cases in the laparoscopic group and 40 cases in the traditional open group.Results:There was no statistically significant difference in basic clinical data between the two groups of patients(P>0.05).In terms of surgical indexes,intraoperative blood loss in the laparoscopic group was(16.60±4.23)ml vs(26.03±8.06)ml,the release rate of intestinal adhesions was 46.7%vs 17.5%,and the total length of the surgical incision was(8.57±1.22)cm vs(17.63±).2.72)cm are superior to the traditional laparotomy group,and the difference is statistically significant(P<0.05).However,the operation time of the laparoscopic group(89.93 ± 18.47)min was slightly inferior to that of the traditional laparotomy group(83.93±19.30)min,and the difference was not statistically significant(P>0.05).In terms of postoperative recovery indexes,the laparoscopic group had advantages over the traditional open group in terms of postoperative drainage tube retention time(5.07±1.11)d vs(7.38±2.94)d,drainage tube drainage volume(78.27±22.71)ml vs(109.33±72.70)ml,postoperative complication rate(3.33% vs 20%),incision pain score(3.16±1.12)points vs(6.25±1.58)points,postoperative hospital stay(7.20±1.30)d vs(8.70 ± 3.16)d.The difference was statistically significant(P<0.05).In addition,laparoscopic gastrointestinal function recovery time(61.67±11.83)h vs(72.55±13.33)h and total hospitalization cost(4.37 ± 0.24)yuan vs(4.40 ± 0.53)yuan also had advantages over traditional open group,but the difference was not statistically significant(P>0.05).Conclusion:Laparoscopy-assisted hartmann reversal is safe and effective,significantly speeds up postoperative recovery,reduces the incidence of postoperative complications and reduces the length of postoperative hospital stay.Therefore,it is worthy of clinical promotion and application.