[The role of Hartmann's procedure and options for its reconstruction at the present time]

Hartmann operation (rectosigmal resection, blind closure of rectum and terminal sigmostomy) is one of the options of treatment of pathology of left colon. Despite great effort to treat such surgical conditions with primary anastomosis, Hartmann's operation is in selected cases preferred. It requires, though, secondary reconstruction, which might be associated with complications.

Analyzing patients after Hartmann's operations with evaluation of risk, complications, morbidity and mortality.

Authors analyzed group of 61 patients, which were operated on in years 2004-2008, with Hartmann's operation performed. They state surgical conditions, Hinchey classification, risk rate according to ASA and MPI, and concommitant diseases.

Of complications, most frequent were wound infections and pneumonia, nine patients (14.7%) died. In presented time period, nineteen reconstructions after Hartmann's procedure were performed. Morbidity in this category was high, no death was noted. Authors analyze factors, that influence decision of operation for pathology of left colon and possibilities of reconstruction after Hartmann's procedure.

Authors state, that Hartmann's procedure has still its place in urgent operations. Reconstruction in feasible in high percentage of patients with minimal mortality, difficulty lies with high morbidity.