[Disunion of colo-rectal anastomosis after surgery]

Breakdown of sutures is the main complication of colonic and rectal surgery. The percentage of breakdowns is between 5 and 10 p. 100. The latter may be obvious as shown by a fistula or by peritonitis. But they may also be latent and present with septicemic shock. One must then detect the breakdown by the association of clinical, radiological and laboratory signs in order to re-operate immediately. Intensive care plays a very important role in the treatment of this lesion. Suture breakdown is sometimes unforseeable, but it may be avoided by taking into consideration certain prophylactic rules which are analysed here.