One hundred elective resections of the left colon and rectum with unprotected manual anastomosis

One hundred consecutive elective resections with hand suture of the left colon and rectum without a protective colostomy are reported. The absence of clinical fistulas, wound infections and abcesses indicates the safety and the feasability of this approach. There was a two per cent mortality rate. The article stresses the importance of a good suturing technique, good preparation, the judicious use of anti-anaerobic drugs, the use of plastic ring drapes and the changing of gloves, drapes and instruments before wound closure. The absence of leakage and of septic complications lowers dramatically the overall complication rate.