title: [Our experience with the Hartmann's operation in colorectal emergencies].
abstract: BACKGROUND
  The role of Hartmann's operation has been revised during the past few years in the context of emergency colorectal surgery: it represents an obligatory choice that enables the simultaneous treatment of the primary disorder and the complication. This study aims to emphasise the importance of this unique surgical choice and to stress that surgeons should not underestimate it.
  
  
  METHODS
  The authors review the literature on the subject and make a retrospective analysis of 228 cases of colorectal surgery from 1988 to 1997 in which Hartmann's operation was performed in 16 patients with the following indications: Hinchey's stage III and IV peritonitis secondary to perforating diverticulitis of the sigma (elective indication) or occlusion of the left colon when preparation could not be accomplished in spite of intraoperative washout.
  
  
  RESULTS
  Post-Hartmann recanalisation was successfully performed in 14 patients.
  
  
  CONCLUSIONS
  The authors' experience and these results concord with the general view that this operation should be reserved for selected cases, in particular colorectal emergencies of a perforating nature; it is less appropriate for intestinal occlusion, although it is always preferable to be too prudent by resorting to Hartmann's operation or protective colostomy rather than risk anastomotic dehiscence.
authors.affiliation: Dipartimento di Chirurgia, Università degli Studi, Catania.
authors.forename: S
authors.initials: S
authors.lastname: Berretta
authors.forename: E
authors.initials: E
authors.lastname: Barbagallo
authors.forename: S
authors.initials: S
authors.lastname: Bonanno
authors.forename: A
authors.initials: A
authors.lastname: D'Agata
authors.forename: M
authors.initials: M
authors.lastname: Berretta
authors.forename: G
authors.initials: G
authors.lastname: Vagnoni
mesh_terms: D003108:Colonic Diseases / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D004630:Emergencies; D006801:Humans; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies
vernacular_title: Nostra esperienza sull'intervento di Hartmann nelle emergenze colorettali.