Dehiscence of the anastomosis after low resection of the rectum is a serious complication with the possible development of sepsis and multiorgan failure. This complication is reported in 10-20% of operations. The incidence of dehiscences can be reduced when known principles of preoperative care are respected but in particular by correct surgical technique. The serious character of this surgical complication can be reduced by a primary derivative stomy. Based on their experience the authors recommend to implement a preventive ileostomy in low resections of the rectum which can be closed already two weeks after the primary operation.