Hartmann's operation as an emergency procedure for perforation of the sigmoid colon. A consecutive series.

A consecutive series of 19 patients with acute perforation of the sigmoid colon, were subjected to Hartmann's procedure. The rationale for primary resection of the diseased segment of the bowel is to remove the source of sepsis. The operation took approximately 2 1/4 hours, the temperature was normalized within 2 days and the hospital stay was 22 days. The perforations were caused by cancer in 4 patients. Half of the patients developed postoperative complications, mainly wound sepsis. There was one postoperative death, caused by pulmonary embolism. Approximately three months later a colorectal anastomosis was performed on 11 patients. Our experience confirms that Hartmann's procedure is the treatment of choice for patients with acute perforation of the sigmoid colon.