ONE STAGE RESECTION AND ANASTOMOSIS OF THE COLON
The pendulum of surgery of the large intestine, according to Hinton,1 has returned to primary resection with primary anastomosis, with or without a complementary ileostomy or colostomy.. The early experiences with this method were discouraging. Billroth, in an analysis of 17 patients operated on by the one stage method, reported a mortality of 60 per cent The exterioization method first practiced by Heinecke, by Paul, and by Bloch, and made popular by von Mikulicz, reduced the mortality from 60 per cent in the material of Billroth to 16.6 per cent in the cases reported by von Mikulicz. The multiple stage exteriorization operation or one of its modifications is now considered the operation of choice for resection of the colon at all levels, excluding the rectum. Despite its many advantages, especially in cases of obstruction of the bowel, the method presented certain
Current Comment. JAMA. 1948;137(8):703–704. doi:10.1001/jama.1948.02890420037011
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