Hartmann’s procedure is most often used if immediate anastomosis is not feasible and considered very high risk of anastomotic leakage. The reversal of Hartmann operation has a significant benefit in patient's quality of life, but there are disadvantages because it is procedure of a high degree of complexity. For reversal of Hartmann operation to be truly beneficial, morbidity rate should be reasonable. The aim of this study is therefore to review clinical outcomes of the conversion of Hartmann procedure and define the complication rate of reversal of Hartmann operation in a contemporary practice. Patients undergoing an elective reversal of Hartmann’s procedure at Chosun University Hospital between January 2011 and December 2016 were included in our analysis, and the medical records were retrospectively reviewed. Total 70 patients underwent Hartmann reversal during this period. There were 33 men (47.1%) and the mean age was 67.7±14.5. The most frequent indications for Hartmann’s procedure were complicated diverticulitis in 37 patients (52.9%). Major morbidity rate was 14.3 % (10 patients), anastomotic leakage rate of 4.3% and mortality rate was 2.9% (2 patients). The most common complication was wound infection (25.7%). Univariate analysis demonstrated that there were no statistically significant variables. This study demonstrates that patients who underwent reversal of their Hartmann’s operation did not have increased postoperative morbidity based on advanced age, higher ASA score, presence of multiple comorbidities, type of operation, and longer operation time.

The aim of this study was to evaluate clinical outcomes of laparoscopic surgery for colorectal cancer within a learning period. A total of 86 consecutive patients who underwent laparoscopic resection for colorectal cancer between January 2010 and December 2011 were investigated retrospectively. The patients were sorted into the early and late group; 43 patients were included in each group. Patient’s clinicopathologic features, perioperative outcomes, morbidity, and mortality were evaluated. The two groups showed similar operative results in terms of operation time, conversion rate to open surgery (16% vs 7%, p=0.313), and the rate of postoperative complication (34.9% vs 37.2%, p=0.313). The most serious complication, anastomotic leak, developed in five and four patients in the early and late group, respectively. Hemoglobin change, which means blood loss indirectly was lower in late phase and was statistically significant (2.3g/dL vs. 1.7g/dL, p=0.007). No difference in TNM stage and number of retrieved lymph nodes (19.2±11.9 vs 18.7±12.7, p=0.847) was observed between the two groups. Laparoscopic surgery for colorectal cancer can be performed safely and effectively even during a learning period, if the operation is performed carefully.

Retroperitoneal liposarcoma is an infrequent malignancy in adulthood arising from mesenchymal tissues. It is often diagnosed when the tumor becomes too large, suppressing adjacent organs and causing symptoms. We report on a case of giant liposarcoma found in a 77-year-old female undergoing surgical resection.