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August 1948

ANASTOMOSIS OF THE ILEUM TO THE LOWER PART OF THE RECTUM AND ANUS: A Report on Experiences With lleorectostomy and lleoproctostomy, With Special Reference to Polyposis

Author Affiliations

From the Department of Surgery, University of Nebraska College of Medicine, Omaha.

Arch Surg. 1948;57(2):276-285. doi:10.1001/archsurg.1948.01240020281010

IN 1901, Lilienthal1 extirpated the colon following ileosigmoidostomy in a young woman for polyposis of the colon. Although rectal polyps were palpable, he did not treat them. Since then, the treatment for polyposis of the colon has developed to where now the accepted treatment is fulguration of the polyps in the rectum and lower part of the sigmoid, followed by ileosigmoidostomy and colectomy. However, in a fair number of such patients, cancer has been reported to have developed subsequently in this rectal segment where the macroscopic polyps or adenomas had been destroyed by fulguration or coagulation. In other words, this disease, which is preponderantly familial, has a genetic predisposition to form polyps in the colon and rectal mucosa, and such activity tends to continue after destruction of the visible small tumor masses, with these new polyps being prone to malignant degeneration. Previous to 1941, I had observed the development

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