The authors report the results and indications of 160 Hartmann's proce
dures performed over a period of 15 years. Between 1978 and 1992, 160
patients (90 males, 70 females), with a mean age of 72, underwent Hart
mann's procedure for rectosigmoid carcinoma in 55 % of cases, for comp
lications of sigmoid diverticulitis in 36 % and for other lesions in 1
4 %. Hartmann's procedure was performed either electively (42 %) or as
an emergency (58%) with a mortality of 6 % and 32 % respectively. The
majority of complications included wound infections or intraperitonea
l abscess, and the overall morbidity was 30 %. Re-establishment of bow
el continuity was performed in 30.7 % of patients, most of whom had be
en initially operated as an emergency for a benign lesion. These 160 c
ases of Hartmann's procedure represent 27 % of the 590 operations perf
ormed during the same period as an emergency or electively for rectosi
gmoid lesion. Hartmann's procedure remains a most effective technique
for emergency surgery for benign or malignant lesions with colonic sep
tic complications, and is also indicated electively for palliative tre
atment of rectosigmoid carcinoma.