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November 1962

The Surgical Management of Carcinoma of the Mid and Upper Rectum: Abdominoperineal Proctosigmoidectomy Without Abdominal Colostomy and with Sphincter Muscle Preservation: A Critical Analysis of 699 Cases

Author Affiliations

Resident, Department of Proctologic Surgery, Temple University Medical Center, Philadelphia.

Arch Surg. 1962;85(5):807-812. doi:10.1001/archsurg.1962.01310050109017

Carcinoma of the colon and rectum constitutes a major medical, social, and economic problem. With the exception of epidermoid carcinoma of the skin, it is the most common malignancy to afflict both men and women. It is estimated that 40,000 people died of this disease within the United States during the last year.

It is stated that 70% to 80% of patients with Duke's A lesion1 can be expected to survive 5 years after surgical extirpation, while the prognosis is progressively more guarded once the muscle-coats or regional lymph nodes are involved, no matter what surgical procedure is instituted. The use of chemotherapeutic agents as an adjunct to surgery is currently being evaluated in this and other centers throughout the country, but the techniques are still in their infancy, and a clear picture of their effectiveness is not as yet available. Therefore, early diagnosis, based on the increased use

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