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Article
July 1949

PRESERVATION OF THE ANAL SPHINCTER IN SURGICAL PROCEDURES IN THE RECTOSIGMOID REGION

Author Affiliations

Head of the Department of Surgery, Doctors Hospital, Washington, D. C.; Surgical Consultant to United States Naval Hospital, Bethesda, Md. WASHINGTON, D. C.

Arch Surg. 1949;59(1):129-146. doi:10.1001/archsurg.1949.01240040132010
Abstract

IN RESECTION of the rectosigmoid region for carcinoma, it has been the practice of a large group of surgeons to remove the anus and the sphincter, substituting a colostomy opening; a smaller, but perhaps no less vocal, group believes that the sphincter can be retained without the penalty of a higher immediate or remote mortality. This amiable feud goes on and on, with concessions from either side, and in all fairness it can be said that both groups have honest convictions. I believe there is enough information available concerning many aspects of the subject to permit some rational decision.

Two questions naturally arise: First, is it possible to retain a functioning anal sphincter without materially increasing the risk of operation and, at the same time, maintain a record of five year cures comparable to that of the colostomizing operation? Second, can the operation be done with the assurance that a

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