IN THE evolution of surgery for the extirpation of carcinoma of the rectum and rectosigmoid, there is now a tendency to revert to the original operations for this malady. In 1898, Cadol,1 in France, published a historical review of the treatment of rectal cancer and reported that Lisfranc in 1826 was the first to extirpate a cancer of the lower part of the rectum. Colostomy was not used in conjunction with operations for removal of malignant lesions of the rectum until fifty years later. Lisfranc concluded that one should operate when the finger could go beyond the upper limits of the diseased area and the perirectal tissues were healthy, so that the rectum and tumor mass could be everted and the whole tumor with the anus excised, leaving a posterior rectal opening or fistula. Modifications of this technic were developed, but the rate of mortality was high, averaging 80