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Updated: Oct 12, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Laparoscopic Hartmann's reversal combined with interval lymphadenectomy after emergency surgery for perforated colon
Tairin Uchino1, Shunichiro Komatsu1, Tatsuki Matsumura2
1Division of Gastroenterological Surgery, Department of Surgery, Aichi Medical University, Nagakute, Japan.
Abstract:
A 55-year-old man underwent Hartmann's procedure for generalized peritonitis caused by perforation of sigmoid colon cancer, which was histologically diagnosed as tubular adenocarcinoma penetrating the muscularis propria (T3). The extent of lymph node dissection was insufficient for the advanced cancer, according to the concept of complete mesocolic excision. Two months after surgery, he underwent laparoscopic Hartmann's reversal, combined with interval lymphadenectomy. En bloc resection of the colostomy, rectal stump and associated mesentery was performed with high ligation of the inferior mesenteric artery. Subsequently, the intestinal continuity was restored by end-to-end anastomosis. The postoperative course was uneventful except for infection at the stoma site. No lymph node metastasis was found by histological examination of the resected specimen, with no evidence of cancer recurrence 8 months after the initial surgery.
