July 26, 1958


Author Affiliations

New York

From the Department of Surgery, Mount Sinai Hospital.

JAMA. 1958;167(13):1602-1605. doi:10.1001/jama.1958.02990300028006

The application of surgical diathermy (electrocoagulation) is described in four cases of rectal neoplasm. Biopsy specimens from the first patient were reported as showing a noninfiltrating adenocarcinoma without adenomatous tissue; after treatment by electrocoagulation the lesion was replaced by a scar, and there was no evidence of recurrence nine months later. In the second patient, biopsy led to the diagnosis of infiltrating adenocarcinoma; electrocoagulation was used because the poor general condition of the patient contraindicated more extensive surgery. Examination 11 months later yielded no evidence of malignancy. In the third, a sessile lesion in the rectum was diagnosed as infiltrating adenocarcinoma at biopsy; 14 months after electrocoagulation of the lesion sigmoidoscopy revealed normal mucosa at the site of the lesion. In the fourth patient, rectal pain of four or five years' duration led to sigmoidoscopy and the finding of an infiltrating carcinoma. This lesion was removed with a cold biopsy forceps, and the base was electrocoagulated; when last seen, the patient was free from gross evidence of rectal malignancy. The authors present evidence, however, that such favorable results from electrocoagulation in rectal cancer are exceptional. For the invasive type of lesion the authors continue to recommend the currently accepted surgical procedures, and they reserve electrocoagulation for those patients who are considered extremely poor surgical risks.