A good surgical operation is conceived in an understanding of the origin and method of dissemination of the disease. It is an attack that is well planned with knowledge of the anatomy involved and with the expectation of a morbidity and mortality reasonably small in relation to the relief that ensues. To the degree in which these fundamental conditions are fulfilled does the operation approach the ideal. In the light of new contributions to the knowledge of both normal and pathologic anatomy and physiology, one must at intervals revaluate one's surgical procedures. In so doing one learns why methods once thought to be theoretically sound have proved unsatisfactory in practice, and one may plan for the future on a more certain basis of fact.
The surgery of carcinoma of the rectum was for many years in the hands of two diametrically opposed groups, the Germans holding to the posterior approach
BARTLETT W, BARTLETT W. A ONE-STAGE COMBINED RESECTION OF THE RECTUM. Arch Surg. 1931;22(5):786–793. doi:10.1001/archsurg.1931.01160050097005
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