THE IMPORTANCE of cancer of the lower part of the bowel cannot be overemphasized when one considers that it still remains the fourth most common malignant process involving the human organism; of those of the gastrointestinal tract, it is second in frequency to cancer of the stomach. In this discussion it is our purpose to consider the preparation of the patient, choice of operative procedure and postoperative treatment, with particular reference paid to the technic of abdominoperineal proctosigmoidectomy without colostomy and preservation of the sphincter musculature.
Advances in management of cancer of the lower part of the bowel have diminished markedly the mortality rate accompanying operative procedures undertaken for this disease. This is well demonstrated in our own series of cases, which includes 640 patients with malignant growths of the anus, rectum and sigmoid colon, shown in table 1.
PREOPERATIVE EVALUATION AND PREPARATION
In order to prepare patients with any