Hartmann's procedure is performed when a carcinoma of the rectum is found to be unresectable either due to local invasion or because the patient is unfit for a major resection. It may also be used in situations where a primary anastomosis would be dangerous, for example, severe perforating diverticulitis.
The lower end of the rectum is closed with sutures or staples and left in situ. The upper end of the bowel is bought out as a descending colostomy.
The residual rectum is thus completely defunctioning. However, its secretions still pass through the anus.
When used for inflammatory conditions, the bowel may be reconnected when local inflammation has resolved, which will be several months later.
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