It is well established that abdominoperineal resection in one or more stages is the operation of choice for cancer of the rectum. Less extensive procedures are justifiable only when the radical operation is specifically contraindicated. However, when one is dealing with cancer of the rectosigmoid, the situation is less clear, for it is possible that in selected cases anterior resection of the rectum followed either by anastomosis or by closure of the rectal stump with permanent colostomy may prove equally satisfactory. Anterior resection offers hope of avoiding permanent colostomy and since it is a less extensive procedure, should have a lower operative mortality.
The rectosigmoid is that portion of the large intestine in which the narrow sigmoid colon undergoes a gradual enlargement before joining the rectum. Its exact position is variable. By some it has been estimated to be about 2 inches (5 cm.) above the superior valve of Houston.