Colotomy and extirpation are two recognized procedures for the relief of malignant disease of the rectum. Both operations offer to the patient a chance of prolonging life; and, in addition, extirpation holds out the possibility of effecting a radical cure, in selected cases.
The choice between these two methods is a question of uncertainty only in a relatively small group of cases, and extirpation is not to be considered in the majority of instances, for the reason that the disease is usually an incurable malady, and by virtue of its concealed position within the rectum its presence is not revealed or even suspected until the growth has existed for some time. Furthermore, it is rare for cancer of the rectum in its incipiency, to manifest itself by any symptom pointing to a lesion within the bowel. This is a familiar observation to all surgeons.
It frequently happens that a patient
ADLER LH. EXTIRPATION AND COLOTOMY IN CASES OF CANCER OF THE RECTUM.. JAMA. 1895;XXV(3):93-94. doi:10.1001/jama.1895.02430290007001b