Abdominoperineal Resection for Carcinoma of the Rectum


In its brief span, American Surgery has progressed far and it is fair to assume that it will make further advances. The progress of thoracic surgery during the past 20 years has been amazing. Fifteen years ago we little thought that the two, three, or four stage operation for hyperthyroidism would be transformed into a single stage procedure with a mortality varying from 1 to 2 per cent. This has been accomplished in part by a better knowledge of the disease, but it is due chiefly to better preoperative treatment. Quite analogous to this has been the progress made in surgery of the colon and rectum. We have a better understanding of the pathologic physiology, surgical technic has been tremendously improved, and x-rays have rendered invaluable contributions to the diagnosis of early lesions of the colon, but it is sad to relate that, in spite of all the previous teachings, digital examination of the rectum is still frequently neglected. Coincidentally also, inspection seems to have fallen into disrepute. It has become too easy, perhaps too cheap, to say “Have an x-ray and see what is wrong.”

Statistics from any institution will show that 75 per cent of the growths in the colon are within reach of the examining finger or the proctoscope and, as every roentgenologist knows, low-lying lesions are much more difficult to diagnose by means of roentgen examination, so that a negative report is not only misleading but gives the patients a false sense of security which may. . .



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