Hartmann’s operation: 100 years in surgery

Abstract

The first idea of stage operations for colon cancer was introduced in 1898 by G. F. Ceidler. The first stage of treatment, he recommended the formation of colostoma above the tumor. At the 30th Congress of French Surgeons in 1921 in Strasbourg, H. Hartmann, a surgeon from Paris, reported on the successful treatment of two patients with cancer of the left half of the colon. In the domestic literature, there were different names of Hartmann’s operation. The first report of its performance in our country belongs to N. N. Petrov, who called this intervention operation Coffey – Hartmann (1929) or the single-step intraperitoneal operation by Hartmann (1939). For many decades, the term «obstructive colon resection» has been widely used in foreign and domestic literature. A two-stage operation under this name was developed and practiced by the American surgeon F.W. Rankin in 1928. At the same time, obstructive resection of the colon by Rankin can be performed only in a planned order, unlike Hartmann’s operation, which is carried out also in case of acute colon obstruction. Thus, the following names of surgical interventions using H. Hartmann’s name are valid and terminologically correct: Hartmann’s sigmoid resection (with formation of a flat sigmostoma and suturing of the sigmoid stump); Hartmann’s resection of the sigmoid and rectum (with formation of a flat sigmostoma and suturing of the stump of the supra-ampular or ampular parts of the rectum); left-sided hemicolectomy of Hartmann type (with formation of flat transversostoma and suturing of sigmoid stump); transverse colon resection of Hartmann type (with formation of flat transversostoma and suturing of transverse colon stump).