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May 11, 1929


JAMA. 1929;92(19):1598-1599. doi:10.1001/jama.1929.92700450006010e

In recent years, clinical and pathologic studies have demonstrated the frequent association of nonmalignant with malignant tumors in the colon and rectum. Polyps of the adenomatous type are especially prone to undergo malignant degeneration. For this reason, it is important to remove a fairly wide margin at the base of the tumor. Growths situated in the lower rectum, accessible to manipulation when the anal sphincters are dilated, do not present any serious difficulties in their satisfactory removal by knife, cautery or surgical diathermy.

A quite different problem is presented, however, when the growth is situated beyond reach of the fingers, high in the rectal ampulla or lower pelvic colon. Ordinary pedunculated polyps attached here may be removed safely with the cold snare, passed through an operating proctoscope. Some years ago, I devised such a snare, adopting as the basic principle the tonsil snare of Douglas, and I have used it successfully in many cases.

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