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September 1952


Author Affiliations

From the Division of Surgery, Mayo Clinic.

AMA Arch Surg. 1952;65(3):406-416. doi:10.1001/archsurg.1952.01260020420008

THIS METHOD of resecting the upper part of the rectum and rectosigmoid was reported in 1948.1 The anastomosis is achieved not by suturing, but by invaginating the sigmoid through the intact anal canal. The particular advantage of the procedure is that fecal continence, rather than only a sphincter capable of contracting, is preserved. At the time of the previous report seven patients had been treated. The increased experience with 41 patients serves as the basis for the present report.

Resections of the rectum with restoration of continuity of the bowel antedated radical amputations of the lower reaches of the bowel by almost a quarter of a century. Procedures of the Kraske2 type, in which continuity is restored by circular suture, proved quite unsatisfactory because of leakage of the anastomosis. Hochenegg,3 three years after the introduction of the Kraske method, attempted to avoid anastomosis by suturing, by use

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