Surgery of the Colon:  Management and Complications

Three to four decades ago the mortality associated with colon and rectal surgery was 20% or greater and the morbidity was high. This experience earlier had led to the development of multiple-staged operations for the management of neoplastic and inflammatory diseases of the large bowel and rectum. With the introduction of chemotherapeutic agents (the sulfonamides, which were poorly absorbed in the gastrointestinal tract)¹ in the late 1930's, the mortality for colon surgery promptly began to fall; and over the next decade it was reduced to approximately 5% in most reports. Shortly after the sulfonamides, antibiotics came into use and aided further the management of patients having colon surgery. Poth^2,3 advocated the combined use of phthalylsulfathiazole (Sulfathalidine) and neomycin as the best prophylactic drugs for suppressing the widest number and variety of intestinal microorganisms. This combination of drugs or some modification of it has been used and recommended by