[Preoperative preparation of the colon with special reference to orthograde intestinal lavage]

The effectiveness of the orthograde lavage of the colon with isotonic saline and 153-electrolyte solution, resp., was checked by means of a comparative prospective study. The most important factor in the pre-operative preparation of the colon is mechanical cleaning which is best performed by way of orthograde lavage leading in 90% of the cases to a complete emptying of the colon. Reduction of the intestinal flora can be improved in addition to lavage by a short prophylaxis with large doses of antibiotics. This method was applied to 100 operations performed in the colorectal region and only in 6% of the cases was an infectious complication observed. Lavage of the colon raises no problems and is well tolerated even by elderly patients. Ileus and the risk of perforation in the gastrointestinal tract are absolute contra-indications. Because of its almost iso-ionic composition the authors prefer the 153-electrolyte solution to isotonic saline. Due to the increase of the extracellular space some blood parameters tend to decrease.