DISADVANTAGES OF SPHINCTER-PRESERVING OPERATIONS FOR CANCER OF THE RECTUM

Abstract

The title of this discussion has been deliberately made provocative to aid those who doubt the wisdom of employing sphincter-preserving operations in cancer of the rectum to decide as soon as possible whether it is justifiable to continue their use. It is the frank purpose of this discussion not to attempt to settle anything definitely but to question the wisdom of using these operations except as palliative procedures and to present recent data from the literature on which at least some impressions concerning this matter may be based. A comparison can now be made of the three operations designed to preserve anal function. One is the procedure employed by Dixon and Wangensteen, which is virtually a low anterior resection with an end-to-end anastomosis. The second was originally proposed by Maunsell and Weir and is also an anterior resection with end-to-end anastomosis, differing from the first only in the method of