[Wound-healing disorders and mortality in one- and multi-stage sigma and rectum resections]

From 1958 to 1978, the Surgical Clinic of the Tübingen University carried out 427 sigmoidal and rectal resections with a one-, two-, or three-stage proceeding. The comparison proves that, as was to be expected, the one-stage resection more often shows an anastomotic insufficiency. On the other hand, there occur less infections of the abdominal wall because of the absence of a smear-infection deriving from the temporary intestinal fistula. The primary lethality through anastomotical complications does not differ in the one-, two-, or three-stage proceeding if in the latter you effect an only mechanical cleaning of the inactive colon leg. The irrigation of the inactivated colon with an antibiotic solution before the tumor resection leads, compared to the cleaning with saline solution, to much less infections of the abdominal wall, less anastomotic insufficiencies and to the reduction of the primary lethality. This three-stage proceeding is, with a lethality of 1,5%, still the most secure action for the patient.