Optimization of surgical tactics after Hartmann surgery

To date, there are more than 200 known ways of forming intestinal stomas, which, with complicated pathology of the colon, is formed in 50-80% of cases. Performing reconstructive and reconstructive operations (RVR) after Hartmann's operations (OH) is the only sure way to get rid of this condition. A large percentage of suture failure in the formation of primary anastomoses due to acute intestinal obstruction (OCN) (up to 34-80%) and, as a consequence, high mortality (up to 40-60%), determine the relevance of the problem under discussion [4;8;12]. These figures have not undergone significant changes over the past 20 years [2;10]. To date, one of the top-priority, controversial and unresolved issues is to determine the optimal timing and the choice of a method for restoring the continuity of the intestinal tube during RVR [1;5;6;11]. To date, more than 500 methods of RVR are known, which indicates an ongoing search [3;8;9]. At the same time, invagination anastomoses stand somewhat apart from others, and also have both positive and negative qualities [7;13]. Improving the results of RVR after Hartmann's operations is relevant for practical healthcare and the health of the country's population, which was the reason for this study.