[Restoration of natural intestinal passage after Hartmann's operation]

From 1972 to 1988 restorative operations were carried out at the Institute of Proctology on 252 patients after resection of the colon by Hartmann's technique. Analysis showed that restoration of natural intestinal passage after Hartmann's operation for resection of the colon is a complex and dangerous surgical intervention. When undertaking such intervention, the surgeon should take into account not only the patient's wish to be relieved from the colostomy, but also correct appraisal of the possibility of accomplishing the restorative operation from the standpoint of the patients' somatic condition, the technical conditions for restoration of intestinal continuity, and his own professional possibilities. In cases of a short rectal stump, various modifications of Duhamel's operation are the most safe and technically executable method for restoration of the natural intestinal passage. Such restorative-reconstructive operations should be carried out in specialized coloproctological clinics.