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July 1956

Experiences with a Sphincter-Preserving Operation: Its Use in the Treatment of Carcinomatous Polyp of the Rectum

Author Affiliations

New York
From the Surgical Division, the Montefiore Hospital.

AMA Arch Surg. 1956;73(1):63-65. doi:10.1001/archsurg.1956.01280010065010

The pull-through operation described by Swenson and Bill1 for the treatment of Hirschsprung's disease has been able to preserve the anal sphincter with continence. Welch and Rheinlander2 have adapted Swenson's operation to the treatment of malignant disease of the upper rectum and lower sigmoid, found approximately 14 to 16 cm. or more proximal to the anal margin. At times anterior resection for the treatment of carcinoma of the rectosigmoid may be inadequate because of the technical difficulty of getting sufficiently distal to the tumor and performing an anastomosis deep in the pelvis.

There have been a group of cases (three) with adenomatous polyp of the rectum with malignant changes approximately 3 to 5 in. from the anal margin that we have felt should be resected but with preservation of the rectal sphincter. The performance of an extremely low anterior resection in these cases is technically difficult. Instead, we