[Hartmann 's procedure. A 30 years one-centre clinical experience].

Henri Hartmann described in 1921 a resection procedure for extended neoplasma of the rectosigmoid junction, in patients who were not eligible for a primary anastomosis. Since then, the technique has been widely applied and well studied. We present a 30 years one-centre clinical experience, with a total amount of 221 patients, in 3 different series. The last series had 65 patients, operated in our clinic between 2000 and 2007. 60 of them had malign tumors of the rectum and colon, while 5 patients had benign diseases. We analysed the surgical indication, the technique details and the evolution. 49 patients had a favourable evolution, 13 of them had different complications and 3 other patients deceased. The reversal of Hartmann's procedure was possible in 24 patients. The method used by us in order to increase the safety of these re-anastomosis was the trans-anastomotic tube, which avoids a protective ileostomy or colostomy.