Hartmann’s procedure: everything we need to know

Abstract

Background. The Hartmann procedure (HP) is an invasive procedure in which the affected portion of colon is removed usually due to diverticulitis especially in stage III and IV, which involve peritonitis or colorectal cancer particularly recto-sigmoid carcinoma. Objective of the study. To Assess the significance, epidemiology, clinical presentation, diagnostic techniques, modern therapeutic techniques and surgical strategies of Hartmann procedure. Material and methods. PubMed, PubMed Central, Medline, Google Scholar databases for assessing the indications and surgical technique of HP, keywords used: „Hartmann procedure”, „diverticulitis with peritonitis”, „complicated colorectal cancer”. Results. A total of 40 full articles were studied and analyzed. The articles contain information about the importance of surgical techniques, the clinical and paraclinical findings, diagnostic methods, as well as the curative management of patients. The Hartmann procedure is still nowadays an operation widely used in emergency situations. The main indications: advanced or complicated recto-sigmoid neoplasm, moderate biological condition of the patient, peritoneal sepsis, intestinal occlusion and fragile colonic wall, especially in the context of inflammatory changes. Conclusion. This thesis offering a thorough summary helps to further knowledge of this surgical technique procedure and attempts to assist medical professionals in making the best decisions possible for patients.