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• W2162610020 abstract "Surgical management tends to evolve over time as a result of contributions from multiple physicians. The management of carcinoma of the rectum is a good example of this. Developments in understanding of the pathology and spread of the tumor, combined with technical advances, have altered significantly the surgical approach, from radical ablative surgery at the start of the twentieth century to restorative sphincter-preserving surgery at the start of the twenty-first century [1]. This is combined with increased awareness of the value of functional outcome and oncologic outcome. In 1908, radicality was considered the key, and Ernest Miles proposed abdominoperineal resection (APER) as the appropriate approach to rectal cancer, based on Halstead’s principles of radical surgery to excise potential areas of lymph node spread, which he considered to be proximal and distal to the tumor [2]. Despite high morbidity and mortality associated with APER, the procedure was supported by William Mayo [3], who believed that sphincter preservation increased morbidity. APER remained the approach of choice for the next 30 years and replaced the posterior approach to rectal tumors that had been advocated by Kraske [4]. Restorative resection for rectal cancer was first performed in the United States by Balfour in 1910 but gained increasing popularity from the 1940s onwards. It was initially applied only to rectosigmoid tumors, with some units still performing APER for rectal tumors into the 1960s. Developments in pathology with respect to the limits of distal rectal cancer spread supported reduction of resection margin distal to the tumor. Because of the need for a permanent colostomy with APER, along with genitourinary dysfunction, numerous techniques for colorectal and coloanal anastomosis were described during the twentieth century. The pull-through" @default.
• W2162610020 created "2016-06-24" @default.
• W2162610020 creator A5026198545 @default.
• W2162610020 creator A5032751131 @default.
• W2162610020 date "2005-04-01" @default.
• W2162610020 modified "2023-10-16" @default.
• W2162610020 title "Proctectomy with Coloanal Anastomosis" @default.
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• W2162610020 doi "https://doi.org/10.1016/j.soc.2004.11.008" @default.
• W2162610020 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/15817233" @default.
• W2162610020 hasPublicationYear "2005" @default.
• W2162610020 type Work @default.

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