Hartmann procedure: place in surgery and what after?

The results of 65 consecutive cases of Hartmann's procedure carried out between 1982/1993 inclusive, were reviewed. There were 41 emergency procedures including 27 cases with complicated carcinoma and 24 elective procedures including 20 with carcinoma, 3 with diverticular disease and one with perirectal haemangioma. Postoperative complications occurred in 25 (38.5%) patients, including 13 (19%) with wound infection. Seven patients had to be reoperated because of intraperitoneal abscess (3 cases) or wound dehiscence (4 cases). There were five (7.7%) postoperative deaths. The mean hospital stay of operation survivors was 16 days (range 8-54). Intestinal continuity has been reestablished in 13 (81.2%) of 16 survivors in the benign disease group and in 4.5% of patients of the malignant group. The mean time to of restoration of continuity was 240 days (range 40-630) after the primary procedure. No one died after these procedures. In five (31.2%) patients postoperative complications were observed: anastomotic leak (2 cases) and wound infection (3 cases). All complications were treated conservatively.