Sphincter-preserving operations for patients with carcinoma of the rectum and rectosigmoid area are becoming more widely accepted. The more enthusiastic proponents of these procedures have learned by bitter experience that the abdominoperineal resection with sacrifice of the anal sphincter is mandatory for those lesions adjacent to the sphincter mechanism. Also, the strongest objectionists must be looking at proper sphincter-preserving operations in selected patients with less disfavor, since reports are made which show that survival rates in properly selected patients are approximately the same for both sphincter-preserving operations and abdominoperineal resections.
There has been a much wider acceptance of preservation of the sphincter mechanism in lesions of the lower sigmoid, and gradually more surgeons are no longer sacrificing the sphincter for lesions of the rectosigmoid. The area of the upper rectum and midrectum is more controversial, but even here improved operative technique and survival rate reports are supporting the contention that
BEST RR, RASMUSSEN JA. Sphincter-Preserving Operations for Cancer of the RectumSpecial Reference to the Incidence and Survival Rates. AMA Arch Surg. 1956;72(6):948-956. doi:10.1001/archsurg.1956.01270240060009