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a particular course of action intended to achieve a result; "the procedure of obtaining a drivers license"; "it was a process of trial and error" (同)process
a mode of conducting legal and parliamentary proceedings

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〈U〉(行動・事情などの)『進行』,進展 / 〈C〉(進行上の)『手順』,方法;(法律上の)『手続き』

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/08/17 12:21:01」(JST)

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Hartmann's operation is the surgical resection of the rectosigmoid colon with closure of the rectal stump and formation of an end colostomy. It was used to treat colon cancer or diverticulitis. These days its use is limited to emergency surgery when immediate anastomosis is not possible, or more rarely it is used palliatively in colorectal tumours.^[1] The procedure was first described by Henri Albert Hartmann in 1921.^[2] The original two-paragraph article in French together with an English translation by Thomas Pézier and a modern commentary is available.^[3] The procedure is described in detail in his book, Chirurgie du Rectum, which was published in 1931 and constituted volume 8 of his Travaux de Chirurgie.^[4]

The Hartmann's procedure with a proximal end colostomy or ileostomy is the most common operation carried out by general surgeons for management of malignant obstruction of the distal colon. During this procedure, the lesion is removed, the distal bowel closed intraperitoneally, and the proximal bowel diverted with a stoma.

The indications for this procedure include:

a. Localized or generalized peritonitis caused by perforation of the bowel secondary to the cancer

b. Viable but injured proximal bowel that, in the opinion of the operating surgeon, precludes safe anastomosis.

Use of the Hartmann's procedure has been associated with a low perioperative mortality of 9%, but at the cost of a colostomy that, in up to two-thirds of patients, is never reversed.

References

^ Balanzoni S, Perrucci A, Pasi L, Montanari M (1997). "[The Hartmann intervention. The current indications and the authors' own experience]". Minerva Chir 52 (4): 383–6. PMID 9265121.
^ Hartmann, H.: 30th Congress Francais de Chirurgie-Process, Verheaux, Memoires, et Discussions, 30:411, 1921
^ Hotouras A (2008). "Henri Hartmann and his operation". Grand Rounds 8: L1–2. doi:10.1102/1470-5206,2008.9001. http://www.grandrounds-e-med.com/articles/gr089001.html.
^ Ronel D, Hardy M (2002). "Henri Albert Hartmann: Labor and discipline.". Curr Surg 59 (1): 59–64. doi:10.1016/S0149-7944(01)00572-4. PMID 16093106.

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1. 急性合併性憩室炎のマネージメント management of acute complicated diverticulitis
2. 人工肛門造設または回腸瘻造設患者のマネージメント management of patients with a colostomy or ileostomy
3. 潰瘍性大腸炎の外科的マネージメント surgical management of ulcerative colitis
4. 急性偽性腸閉塞（オギルビー症候群） acute colonic pseudo obstruction ogilvies syndrome
5. 小腸および大腸におけるクローン病の外科的マネージメント operative management of crohn disease of the small bowel and colon

English Journal

Differential decay kinetics of human cytomegalovirus glycoprotein B genotypes following antiviral chemotherapy.

Emery VC, Manuel O, Asberg A, Pang X, Kumar D, Hartmann A, Preiksaitis JK, Pescovitz MD, Rollag H, Jardine AG, Gahlemann CG, Humar A.SourceCentre for Virology, Department of Infection, University College Medical School, London, United Kingdom.
Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.J Clin Virol.2012 May;54(1):56-60. Epub 2012 Mar 10.
BACKGROUND: The impact of different cytomegalovirus (HCMV) glycoprotein B (gB) genotypes on pathogenesis remains controversial.OBJECTIVES: To investigate the effect of gB genotypes either as single infections or as part of multiple infections on the early kinetics of response to ganciclovir therapy.
PMID 22410132

Alu Sx repeat-induced homozygous deletion of the StAR gene causes lipoid congenital adrenal hyperplasia.

Eiden-Plach A, Nguyen HH, Schneider U, Hartmann MF, Bernhardt R, Hannemann F, Wudy SA.SourceDepartment of Biochemistry, Saarland University, Saarbrücken, Germany.
The Journal of steroid biochemistry and molecular biology.J Steroid Biochem Mol Biol.2012 May;130(1-2):1-6. Epub 2012 Jan 11.
Lipoid congenital adrenal hyperplasia (Lipoid CAH) is the most severe form of the autosomal recessive disorder CAH. A general loss of the steroid biosynthetic activity caused by defects in the StAR gene manifests as life-threatening primary adrenal insufficiency. We report a case of Lipoid CAH cause
PMID 22249004

Japanese Journal

Factors Affecting Reversal Following Hartmann's Procedure : Experience from Two District General Hospitals in the UK

OLUKAYODE MATTHEW TOKODE,AKINGBOYE AKINFEMI,COKER OLUJINMI
Surgery today : the Japanese journal of surgery 41(1), 79-83, 2011-01-01
NAID 10027818719

Pathology in Continuous Infusion Studies in Rodents andNon-Rodents and ITO (Infusion Technology Organisation)-Recommended Protocol for Tissue Sampling and Terminology for Procedure-Related Lesions

Weber Klaus,Mowat Vasanthi,Hartmann Elke,Razinger Tanja,Chevalier Hans-Jörg,Blumbach Kai,Green Owen P.,Kaiser Stefan,Corney Stephen,Jackson Ailsa,Casadesus Agustin
Journal of Toxicologic Pathology 24(2), 113-124, 2011
… Therefore, ITO proposes a tissue sampling procedure and a standard nomenclature for pathological lesions for all sites and tissues in contact with the port-access and/or catheter system. …
NAID 130000930501